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Psychological

and Physiological

Trauma Research

 

 

Seize Your Journeys

 

_______________________

Traumatic stress is found in many competent, healthy, strong, good people.  No one can completely protect themselves from traumatic experiences.  Many people have long-lasting problems following exposure to trauma.  Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy.  What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences.  Having symptoms after a traumatic event is NOT a sign of personal weakness.  Given exposure to a trauma that is bad enough, probably all people would develop PTSD.

By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment.

_______________________

 

Secure Attachments as a Defense Against Trauma

 “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses.  Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses.  The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal.  Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984).  In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).”  van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds.  1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society.  New York and London: Guilford Press. .p. 185

 

Eating Disorders

 “The Eating Disorders are characterized by severe disturbances in eating behavior.  This section includes two specific diagnoses, Anorexia Nervosa and Bulimia Nervosa.  Anorexia Nervosa is characterized by a refusal to maintain a minimally normal body weight.  Bulimia Nervosa is characterized by repeated episodes of binge eating followed by inappropriate compensatory behaviors such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.  A disturbance in perception of body shape and weight is an essential feature of both Anorexia Nervosa and Bulimia Nervosa.  An Eating Disorder Not Otherwise Specified category is also provided for coding behaviors that do not meet criteria for a specific Eating Disorder.

          Simple obesity is include in the International Classification of Diseases (ICD) as a general medical condition but does not appear in DSM-IV because it has not been established that it is consistently associated with a psychological or behavioral syndrome.  However, when there is evidence that psychological factors are of importance in the etiology or course of a particular case of obesity, this can be indicated by noting the presence of Psychological Factors Affecting Medical Condition.

          Disorders of Feeding and Eating that are usually first diagnosed in infancy or early childhood (i.e., Pica, Rumination Disorder, and Feeding Disorder of Infancy or Early Childhood) are included in the section “Feeding and Eating Disorders of Infancy or Early Childhood.

 Anorexia Nervosa

 Diagnostic Features

The essential features of Anorexia Nervosa are that the individual refuses to maintain a minimally normal body weight, is intensely afraid of gaining weight, and exhibits a significant disturbance in the perception of the shape or size of his or her body.  In addition, postmenarcheal females with this disorder are amenorrheic.  (The term anorexia is a misnomer because loss of appetite is rare.)

          The individual maintains a body weight that is below a minimally normal level for age and height (Criterion A).  When Anorexia Nervosa develops in an individual during childhood or early adolescence, there may be failure to make expected weight gains (i.e., while growing in height) instead of weight loss.

Criterion A provides a guideline for determining when the individual meets the threshold for being underweight.  It suggests that the individual weigh less than 85% of that weight that is considered normal for that person’s age and height (usually computed using one of several published versions of the Metropolitan Life Insurance tables or pediatric growth charts.).  An alternative and somewhat stricter guideline (used in the ICD-10 Diagnostic Criteria for research) requires that the individual have a body mass index (BMI) (calculated as weight in kilograms/height in meters2) equal to or below 17.5kg/m2.  These cutoffs are provided only as suggested guidelines for eh clinician, since it is unreasonable to specify a single standard for minimally normal weight that applies to all individuals of a given age and height.  In determining a minimally normal weight, the clinician should consider not only such guidelines but also the individual’s body build and weight history.

Usually weight loss is accomplished primarily through reduction in total food intake.  Although individuals may begin by excluding from their diet what they perceive to be highly caloric foods, most eventually end up with a very restricted diet that is sometimes limited to only a few foods.  Additional methods of weight loss include purging (i.e., self-induced vomiting or the misuse of laxative or diuretics) and increased or excessive exercise.)

Individuals with this disorder intensely fear gaining weight or becoming fat (Criterion B).  This intense fear of becoming fat is usually not alleviated by the weight loss.  In fact, concern about weight gain often increases even as actual weight continues to decrease.

The experience and significance of body weight and shape are distorted in these individuals (Criterion C).  Some individuals feel globally overweight.  Others realize that they are thin but are still concerned that certain parts of their bodies, particularly the abdomen, buttocks, and thighs are “to fat.”  They may employ a wide variety of techniques to estimate their body size and weight, including excessive weighing, obsessive measuring of body parts, and persistently using a mirror to check for perceived areas of “fat.”  The self-esteem of individuals with Anorexia Nervosa is highly dependent on their body shape and weight.  Weight loss is viewed as an impressive achievement and a sign of extraordinary self-discipline, whereas weight gain is perceived as an unacceptable failure of self-control.  Though some individuals with this disorder may acknowledge being thin, they typically deny the serious medical implications of their malnourished state.

In postmenarcheal females, amenorrhea (due to abnormally low levels of estrogen secretion that are due in turn to diminished pituitary secretion of follicle-stimulating hormone [PSH] and luteinizing hormone [LH]) is an indicator of physiological dysfunction in Anorexia Nervosa (Criterion D.)  Amenorrhea is usually a consequence of the weight loss but, in a minority of individuals, may actually precede it.  In prepubertal females, menarche may be delayed by the illness.

The individual is often brought to professional attention by family members after marked weight loss (or failure to make expected weight gains) has occurred.  If individuals seek help on their own, it is usually because of their subjective distress over the somatic and psychological sequelae of starvation.  It is rare for an individual with Anorexia Nervosa to complain of weight loss per se.  Individuals with Anorexia Nervosa frequently lack insight into, or have considerable denial of, the problem and may be unreliable historians.  It is therefore often necessary to obtain information form parents or other outside sources to evaluate the degree of weight loss and other features of the illness.”  p. 583-584.

 Bulimia Nervosa

 “Diagnostic Features

          The essential features of Bulimia Nervosa are binge eating and inappropriate compensatory methods to prevent weight gain.  In addition, the self-evaluation of individuals with Bulimia Nervosa is excessively influenced by body shape and weight.  To qualify for the diagnosis, the binge eating and the inappropriate compensatory behaviors must occur, on average, at least twice a week for 3 months (Criterion C.)

          A binge is defined as eating in a discrete period of time an amount of food that is definitely larger than most individuals would eat under similar circumstances (Criterion A1.).  The clinician should consider the context in which the eating occurred—what would be regarded as excessive consumption at a typical meal might be considered normal during a celebration or holiday meal.  A “discrete period of time” refers to a limited period, usually less than 2 hours.  A single episode of binge eating need not be restricted to one setting.  For example, an individual may begin a binge in a restaurant and then continue it on returning home.  Continual snacking on small amounts of food throughout the day would not be considered a binge.

          Although the type of food consumed during the binge varies, it typically includes sweet, high-calorie foods such as ice cream or cake.  However, binge eating appears to be characterized more by an abnormality in the amount of food consumed than by a craving for a specific nutrient, such as carbohydrate.  Although individuals with Bulimia Nervosa consume more calories during an episode of binge eating than persons without Bulimia Nervosa consume during a meal, the fractions of calories derived from protein, fat, and carbohydrate are similar.

          Individuals with Bulimia Nervosa are typically ashamed of their eating problems and attempt to conceal their symptoms.  Binge eating usually occurs in secrecy, or as inconspicuously as possible.  An episode may or may not be planned in advance and is usually (but not always) characterized by rapid consumption.  The binge eating often continues until the individual is uncomfortably, or even painfully, full.  Binge eating is typically triggered by dysphoric mood states, interpersonal stressors intense hunger following dietary restraint, or feelings related to body weight, body shape, and food.  Binge eating may transiently reduce dysphoria, but disparaging self-criticism and depressed mood often follow.

          An episode of binge eating is also accompanied by a sense of lack of control (Criterion A2).  An individual may be in a frenzied state while binge eating, especially early in the course of the disorder.  Some individuals describe a dissociative quality during, or following, the binge episodes.  After Bulimia Nervosa has persisted for some time, individuals may report that their binge-eating episodes are no longer characterized by an acute feeling of loss of control, but rather by behavioral indicators of impaired control, such as difficulty resisting binge eating or difficulty stopping a binge once it has begun.  The impairment in control associated with binge eating in bulimia Nervosa is not absolute; for example, an individual may continue binge eating while the telephone is ringing, but will cease if a roommate or spouse unexpectedly enters the room.

          Another essential feature of Bulimia Nervosa is the recurrent use of inappropriate compensatory behaviors to prevent weight gain (Criterion B).  Many individuals with Bulimia Nervosa employ several methods in their attempt to compensate for binge eating.  The most common compensatory technique is the induction of vomiting after an episode of binge eating.  This method of purging is employed by 80%-90% of individuals with Bulimia Nervosa who present for treatment of eating disorders clinics.  The immediate effects of vomiting include relief from physical discomfort and reduction of fear of gaining weight.  In some cases, vomiting becomes a goal in itself, and the person will binge in order to vomit or will vomit after eating a small amount of food.  Individuals with Bulimia Nervosa may use a variety of methods to induce vomiting, including the use of fingers or instruments to stimulate the gag reflex.  Individuals generally become adept at inducing vomiting and are eventually able to vomit at will.  Rarely, individuals consume syrup of ipecac to induce vomiting.  Other purging behaviors include the issue of laxatives and diuretics.  Approximately one-third of those with Bulimia Nervosa misuse laxatives after binge eating.  Rarely, individuals with the disorder will misuse enemas following episodes of binge eating, but this is seldom the sole compensatory method employed.

          Individuals with Bulimia Nervosa may fast for a day or more or exercise excessively in an attempt to compensate for binge eating.  Exercise may be considered to be excessive when it significantly interferes with important activities, when it occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complications.  Rarely, individuals with this disorder may take thyroid hormone in an attempt to avoid weight gain.  Individuals with diabetes mellitus and Bulimia Nervosa may omit or reduce insulin doses in order to reduce the metabolism of food consumed during eating binges.

          Individuals with Bulimia Nervosa place an excessive emphasis on body shape and weight in their self-evaluation, and these factors are typically the most important ones in determining self-esteem (Criterion D).  Individuals with this disorder may closely resemble those with Anorexia Nervosa in their fear of gaining weight, in their desire to lose weight, and in the level of dissatisfaction with their bodies.  However, a diagnosis of Bulimia Nervosa should not be given when the disturbance occurs only during episodes of Anorexia Nervosa (Criterion E).”  p. 589-591

 

Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.

 

 

 

LifeSpan Developmental Trauma

 

Trauma and Geriatrics

 

Title: Neurobehavioral effects following geriatric head injury.

Author(s)/Editor(s): Cisewski, Dawn Marie

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 62(9-B) Apr 2002, US: Univ Microfilms International; 2002, 4213

Abstract/Review/Citation: This study compared the acute neuropsychological

effects of a mild head injury in a geriatric population and a young adult

population. Forty-one young adult individuals (mean age = 23.6 years, s.d. =

3.1) and 29 geriatric individuals (mean age = 67.1 years, s.d. = 4.4) were

evaluated using a standard neuropsychological trauma battery at Allegheny

General Hospital following admission to the trauma unit. This study also

examined the reliability and utility of specific neuropsychological measures

in differentiating between individuals who were diagnosed with a head injury

and those who were not. In addition to the aforementioned groups, the

neuropsychological battery was administered to 10 non-head injured young adult

trauma patients (mean age = 25.1, s.d. = 3.84) and 15 non-head injured

geriatric trauma patients (mean age = 68.7, s.d. = 6.84). Results of the study

indicated significant differences on memory, attention/concentration, and

executive functioning for age. However, no significant differences were found

on these measures for head injured vs. non-head injured, and no interaction

between age and head injury was found. These findings were further supported

by the results of the analyses using age appropriate norms, in which no

significant differences were found for these groups on measures of memory and

attention/concentration. The findings of this study suggest that premorbidly

healthy geriatric populations suffer similar neuropsychological effects

following a mild head injury as a young adult population. This study also

raises the possibility that the assessment and diagnostic procedures of

individuals who are admitted to a hospital following a fall or motor vehicle

accident may need to be refined. The lack of significant differences between

head injured and non-head injured individuals raises the possibility that

factors such as diagnostic criteria, referral procedures, and psychological or

physical distress affected neuropsychological test performance. ========================================

 

Title: Contribution of PTSD/POW history to behavioral disturbances in dementia.

Author(s)/Editor(s): Verma, Swapna; Orengo, Claudia A.; Maxwell, Rebecca; Kunik, Mark E.; Molinari, Victor A.; Vasterling, Jennifer J.; Hale, D. Danielle

Source/Citation: International Journal of Geriatric Psychiatry: Special Issue: 

Vol 16(4) Apr 2001, US: John Wiley & Sons Inc; 2001, 356-360

Abstract/Review/Citation: As many WW II and Korean Conflict veterans suffering

from posttraumatic stress disorder (PTSD) grow older, increasing numbers will

be diagnosed with dementia. The authors retrospectively analyzed patients with

dementia, comparing the behavioral disturbances of those with vs without PTSD.

It was hypothesized that due to the additive effect of the neurobiological and

behavioral changes associated with PTSD and dementia, the dementia with PTSD

group would show more agitation and disinhibition than the dementia without

PTSD group. 16 Ss with diagnoses of dementia and PTSD were matched on age and

Mini-Mental States Examination scores to 16 Ss with dementia without PTSD. Ss

with diagnoses of dementia with PTSD did not differ significantly in their

clinical presentation, hospital course, and condition at discharge from Ss

with dementia without PTSD. Significantly more PTSD Ss were prescribed

anti-depressants compared to the non-PTSD group. Within the PTSD group, the

subgroup of Ss who were former POWs had a higher mean score for paranoia and

less verbal agitation. This study reveals that a diagnosis of PTSD alone is

not sufficient to influence behavior in veterans with dementia; however, the

authors also present provocative results that patients with more severe trauma

(POW) do have changes in their behavior.

========================================

 

Title: Clinical perspectives on elderly sexuality.

Author(s)/Editor(s): Hillman, Jennifer L.

Source/Citation: New York, NY, US: Kluwer Academic/Plenum Publishers; 2000, (ix,

206) Issues in the practice of psychology.

Abstract/Review/Citation: With the growth of the older adult population and the

increasing need for health care providers with geriatric training, the author

suggests that students and practitioners must become familiar with the

multifaceted issues of sexuality. This book features a combination of

research findings, clinical case studies, and specific guidelines for

assessment and intervention. A variety of topics typically neglected in this

population, such as body image and eating disorders, HIV, the long term impact

of sexual trauma in late life, sexuality in institutional settings, sexuality

for partners of older adults with dementia and other chronic illnesses,

traditional and nontraditional relationships, and information about

medications that can cause sexual dysfunction, are reviewed in detailed. 

In addition, practitioners are given practical suggestions for interviewing

older adults about sexual issues, working with character-disordered older

adults, managing sexualized transference in the therapeutic relationship,

mediating conflict between professionals on interdisciplinary teams, and

assessing HIV and HIV-induced dementia.  The suggested audience for this

book is clinicians and students of psychology, social work, gerontology,

sociology, and physical therapy.

========================================

 

Title: A review of the phenomenology and cognitive neuropsychological origins of

the Capgras syndrome.

Author(s)/Editor(s): Edelstyn, N. M. J.; Oyebode, F.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 14(1) Jan

1999, US: John Wiley & Sons Inc; 1999, 48-59

Abstract/Review/Citation: Reviews the literature on the epidemiology, etiology,

neuroanatomy and neuropsychology of Capgras syndrome (CS). CS is characterized

by the delusional belief that one or a few highly familiar people have been

replaced by impostors who are physically very similar to the original(s). The

patient acknowledges that the double and known person look alike, but

maintains the belief that the significant person, in psychological terms, is

absent. CS is relatively rare, occurring predominantly in the context of

schizophrenia, and was traditionally considered to have its origins in

psychodynamic conflict. More recently, it has been estimated that between 21

and 40% of cases are associated with organic disorders, which include

dementia, head trauma, epilepsy and cerebrovascular disease. Neuroimaging

evidence suggests a link between CS and right hemisphere abnormalities,

particularly in the frontal and temporal regions. Neuropsychological research

has provided empirical support for these findings, by consistently reporting

the presence of impairments in facial processing-an established right

hemisphere function.

========================================

 

Title: Handbook of counseling and psychotherapy with older adults.

Author(s)/Editor(s): Duffy, Michael

Source/Citation: New York, NY, US: John Wiley & Sons, Inc; 1999, (xx, 721)

Abstract/Review/Citation: This handbook provides a much needed resource in

treatment approaches for mental health professionals who provide counseling

and psychotherapy to older clients. Part I focuses on a series of treatment

modalities, including the use of psychotherapy process, group and expressive

approaches, family and intergenerational interventions, and social and

community interventions. Part II provides conceptual and best practice

interventions for a series of specific problems. This volume will be useful to

a variety of interested persons, including experienced geropsychologists and

geropsychiatrists, geropsychiatric nurses and social workers, and counselors

who focus on mental health and aging. It will also be an important resource

for experienced general therapists who wish to develop greater proficiency in

working with older adults.

Notes/Comments:  Preface Acknowledgments Part One: Approaches to psychotherapy with older adults Issues in psychotherapy process with older adults Using process dimensions in psychotherapy: The case of the older adult Michael Duffy Transferential and countertransferential processes in therapy with older adults Nancy A. Newton

and Jordan Jacobowitz Adjusting to role loss and leisure in later life Jane E.

Myers Addressing late life developmental issues for women: Body image,

sexuality, and intimacy Royda G. Crose Developmental issues in psychotherapy

with older men Margaret Hellie Huyck and David L. Gutmann Existential issues

of hope and meaning in late life therapy Claire M. Brody It takes two:

Therapeutic alliance with older clients Helen Q. Kivnick and Audrey Kavka The

impact of cultural differences in psychotherapy with older clients: Sensitive

issues and strategies Pamilla Morales Group and expressive therapy approaches

Using reminiscence and life review as natural therapeutic strategies in group

therapy Victor Molinari Integrated group approaches with the early stage

Alzheimer's patient and family Robert E. Reichlin The role of art therapy in

aiding older adults with life transitions Jules C. Weiss Using music therapy

in treating psychological problems of older adults Suzanne B. Hanser

Therapeutic issues and strategies in group therapy with older men David G.

Sprenkel Family and intergenerational interventions Realizing power in

intergenerational family hierarchies: Family reorganization when older adults

decline Sara Honn Qualls Couple therapy with long-married older adults Erlene

Rosowsky Dynamics and treatment of middle-generation women: Heroines and

victims of multigenerational families Donna S. Davenport Family disruption:

Understanding and treating the effects of dementia onset and nursing home

placement Deborah W. Frazer Sexual dysfunction: Using an interdisciplinary

team to combine cognitive-behavioral and medical approaches Antonette M. Zeiss

and Robert A. Zeiss Social and community interventions Preventive

interventions for older adults Candace Konnert, Margaret Gatz and E. A. Meyen

Hertzsprung Enhancing mental health climate in hospitals and nursing homes:

Collaboration strategies for medical and mental health staff Karen Sanders, Jo

Ann Brockway, Beatrice Ellis, Elizabeth M. Cotton and June Bredin

Environmental design features and the well-being of older persons M. Powell

Lawton Critical issues and strategies in mental health consultation in nursing

homes Michael A. Smyer and Maureen Wilson Prevention and promotion models of

intervention for strengthening aging families Gregory C. Smith Part Two:

Treatment approaches for selected problems Personality disorders The effect of

personality disorder on Axis I disorders in the elderly Joel Sadavoy Treating

hypochondria in later life: Personality and health factors Damond

Logsdon-Conradsen and Lee Hyer A biopsychosocial approach to treatment of

schizophrenia in late life Stephen J. Bartels, Kristin J. Levine and Kim T.

Mueser Dynamics and treatment of narcissism in later life Jordan Jacobowitz

and Nancy A. Newton Anxiety and mood disorders Interpersonal psychotherapy for

late-life depression Gregory A. Hinrichsen Cognitive-behavioral therapy for

the treatment of late-life distress David W. Coon, Kenneth Rider, Dolores

Gallagher-Thompson and Larry Thompson Strategies for treating generalized

anxiety in the elderly Melinda A. Stanley and Patricia M. Averill Treating

obsessive-compulsive disorder in older adults: A review of strategies John E.

Calamari and Karen Lynn Cassiday The effects of trauma: Dynamics and treatment

of PTSD in the elderly Lee Hyer A guide to current psychopharmacological

treatments for affective disorders in older adults: Anxiety, agitation, and

depression Iris R. Bell Adjunctive psychological treatments for organic

disorders Reaching the person behind the dementia: Treating comorbid affective

disorders through subvocal and nonverbal strategies Michael Duffy Current

concepts and techniques in validation therapy Naomi Feil Memory training for

older adult medical patients in a primary health care setting Martha Li Chiu

Behavior disorders Management of alcohol abuse in older adults Larry W. Dupree

and Lawrence Schonfeld Psychotherapy with the suicidal elderly: A

family-oriented approach Joseph Richman Ethics of treatment in geropsychology:

Status and challenges J. Ray Hays Author index Subject index therapeutic

approaches in counseling & psychotherapy for older adults

========================================

 

Title: The effects of trauma: Dynamics and treatment of PTSD in the elderly.

Author(s)/Editor(s): Hyer, Lee

Source/Citation: Handbook of counseling and psychotherapy with older adults.,

New York, NY, US: John Wiley & Sons, Inc; 1999, (xx, 721), 539-560

Source editor(s): Duffy, Michael (Ed)

Abstract/Review/Citation: The study of stress and trauma in older people,

especially PTSD, is fraught with problems related to developmental issues and

life-span patterns. In this chapter, the authors consider stress as it applies

to older people, present research data on the general curative factor of

trauma, and address issues of the care of older victims. A treatment model for

older trauma victims is presented, along with a case illustration outlining

the features of the model.

========================================

 

Title: An assessment of Nazi concentration camp survivors for posttraumatic

stress disorder and neuropsychological concomitants.

Author(s)/Editor(s): Brody, Julie M.

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 60(2-B) Aug 1999, US: Univ. Microfilms International;

1999, 0820

Abstract/Review/Citation: This study compared World War II survivors of Nazi

concentration camps, survivors who spent the majority of the war in ghettos,

hiding, labor camps, etc., and immigrant comparisons who fled Europe before

the war, on measures of affective and cognitive functioning. The total sample

consisted of 18 females (45%) and 22 males (55%), and the groups were not

balanced for gender. Brief historical interviews were conducted to gather

information about wartime/immigration conditions including illnesses,

beatings, head injury, and excessive weight loss. The Geriatric Depression

Scale and Structured Clinical Interview for DSM-IV-Past and Current Major

Depressive Episodes were administered to measure lifetime/current prevalence

of depression. The PTSD Checklist (PCL-S) was utilized to assess for current

PTSD symptom severity and presence of the disorder. The neuropsychological

measures employed were the Animal Naming Test, California Verbal Learning

Test, Digit Vigilance Test, Logical Memory and Visual Reproduction subtests of

the Wechsler Memory Scale-Revised, Raven's Coloured Progressive Matrices,

Trail Making Test-Parts A and B, and WAIS-R Vocabulary subtest. Premorbid Full

Scale IQ scores were estimated using a regression equation involving

Vocabulary scores and demographic variables. Concentration camp survivors

reported a significantly higher incidence of typhus, beatings, and head

injuries during wartime/immigration periods. They reported higher severity of

current PTSD symptoms overall than non-concentration camp survivors and

immigrant comparisons, but did not qualify for formal PTSD diagnoses more

often than the other groups. On the PTSD Checklist, avoidance symptoms were

endorsed more frequently by concentration camp survivors than the other

groups; however, the symptoms most commonly reported by both Holocaust

survivor groups were intrusive thoughts and memories of the war and distress

prompted by reminders of the trauma. Concentration camp survivors displayed

significantly poorer verbal memory skills than the non-concentration camp

survivors and immigrant comparisons on immediate and delayed recall trials of

the Wechsler Memory Scale-Revised paragraph-length stories, and intruded

significantly more novel words on recall trials of the California Verbal

Learning Test shopping list. The three groups performed statistically

similarly on the remaining neuropsychological measures. More than 50 years

after wartime internment, survivors of Nazi concentration camps continue to

demonstrate post traumatic symptomatology as well as neuropsychological

concomitants, specifically in the domain of verbal memory.

========================================

 

Title: Using atypical neuroleptic drugs to treat agitation in patients with a

brain injury: A review.

Author(s)/Editor(s): Burnett, Derek M.; Kennedy, Richard E.; Cifu, David X.;

Levenson, James

Source/Citation: NeuroRehabilitation; Vol 13(3) 1999, Netherlands: IOS Press;

1999, 165-172

Abstract/Review/Citation: Agitation during brain injury rehabilitation remains a

significant impediment to expedient and effective care. While health care

providers differ in their definition of agitation, it is agreed that treatment

is usually best achieved using an interdisciplinary approach that includes

psychiatry and rehabilitation professionals. Neuroleptic drugs have been used

to effectively treat agitation but have a side effect profile that may have

long-term consequences on cognition and motor recovery. This literature review

presents the typical and atypical neuroleptics used to treat agitation,

research in support of their use, guidelines for drug selection, and special

considerations for trauma-related agitation in the elderly brain injured

population.

========================================

 

Title: Phenomenology and treatment of trauma in later life.

Author(s)/Editor(s): Hyer, Lee; Woods, M. G.

Source/Citation: Cognitive-behavioral therapies for trauma., New York, NY, US:

The Guilford Press; 1998, (xii, 431), 383-414

Source editor(s): Follette, Victoria M. (Ed)

Abstract/Review/Citation: Given that thinking in terms of posttraumatic stress

disorder (PTSD) will yield an imperfect picture of how trauma is adjusted to

in later life, the authors of this chapter address 3 issues. First, they

consider age and its role in the trauma experience. They primarily address

combat trauma, as many of the current older cohort of trauma sufferers

experienced trauma in World War II and the Korean War. Second, they look at

treatment studies and psychotherapy as these apply to older people and trauma

victims. Third, a cognitive-behavioral model of treatment is provided.

Finally, the authors consider both the caregiver and assessment. A brief case

example is presented.

========================================

 

Title: Rehabilitation.

Author(s)/Editor(s): Goldstein, Gerald; Beers, Sue R.

Source/Citation: New York, NY, US: Plenum Press; 1998, (xvi, 292) Human brain

function:  Assessment and rehabilitation.

Abstract/Review/Citation: This volume is the 4th in a series that is dedicated

to the topic of human brain function. This book is focused on assessing brain

function as it affects various aspects of the patient's capabilities from the

perspectives of the rehabilitation specialties. These specialties generally

assess brain function from a broader perspective than neuroimaging or even

neuropsychology. That is, they are interested in how the brain interacts with

the environment and impacts the patient's ability to manage practical aspects

of his or her daily life.

Notes/Comments:  Part I: Introduction Introduction to rehabilitation assessment Gerald Goldstein and Sue R. Beers Part II: The rehabilitation specialties Occupational therapy assessment of adult brain function Margo B. Holm and Joan C. Rogers Physical therapy Kathye E. Light, Marie A. Reilly and Martha Clendenin Rehabilitation assessment and planning for neurogenic communication disorders Patrick J. Doyle Dynamics of

rehabilitation nursing Shirley P. Hoeman Geriatric rehabilitation Joan C.

Rogers and Margo B. Holm Part III: Assessment for rehabilitation Functional

assessment Michael McCue and Michael Pramuka Assessment of sensory and motor

function Paul D. Hansen and Lynette S. Chandler Assessment of external

prostheses Jacqueline Perry and Edmond Ayyappa Part IV: Clinical

considerations Rehabilitation assessment and planning for head trauma

Anne-Lise Christensen and Thomas W. Teasdale Neuropsychological assessment for

planning cognitive interventions William Drew Gouvier, Judith R. O'Jile and

Laurie M. Ryan Rehabilitation assessment and planning for children and adults

with learning disabilities Sue R. Beers Assessment and planning for memory

retraining Sue R. Beers and Gerald Goldstein Assessment and planning for

psychosocial and vocational rehabilitation Lynda J. Katz Cognitive remediation

of psychotic patients Robert S. Kern and Michael F. Green Index assessment

& rehabilitation of human brain function, patients with disorders

========================================

 

Title: Early loss of mother or father predicts depression in old age.

Author(s)/Editor(s): Kivelae, Sirkka-Liisa; Luukinen, Heikki; Koski, Keijo; Viramo, Petteri; Pahkala, Kimmo

Source/Citation: International Journal of Geriatric Psychiatry; Vol 13(8) Aug

1998, US: John Wiley & Sons Inc; 1998, 527-530

Abstract/Review/Citation: The independent predictive roles of early losses,

personality traits, acute losses, and long-term stress situations for the

occurrence of depression in elderly Finns were described using a longitudinal

design. The persons non-depressed in an epidemiological study in 1984-1985

were interviewed in 1989-1990 (N = 679) and the occurrence of depression was

determined according to DSM-III criteria. Logistic regression models were used

to assess the independent roles of the hypothesized factors as predictors. An

early loss of the mother among men and an early loss of the father among women

independently predicted the occurrence of depression in logistic regression

models. Older age in men, and a higher number of symptoms, the occurrence of

previous depression, and not living alone in women were also independent

predictors. In men, impaired functional abilities and poor self-perceived

health tended to predict depression. In conclusion, the psychological trauma

that develops upon the experience of an early parental loss contributes to the

development of depression even in old age. The role of stressors in life as

independent predictors of depression in old age was also ascertained.

========================================

 

Title: Aging and cognition.

Author(s)/Editor(s): Keefover, Robert W.

Source/Citation: Neurologic Clinics; Vol 16(3) Aug 1998, US: W.B. Saunders &

Co.; 1998, 635-648

Abstract/Review/Citation: Reviews the age-related cognitive deficits of the

elderly. While these changes are often attributable to serious dementing

illnesses such as Alzheimer's disease (AD), a surprising number result from

apparently normal aging processes. The effects of senescence on cognition may

be indirect (i.e., gait instability leading to falling and subsequent head

trauma); however, they may have a more direct and subtle impact on the brain.

The evidence available to date suggests that only a limited range of cognitive

domains are susceptible to these aging effects. It is suggested that perhaps

the most important are short-term memory functions. As increasing numbers of

elderly patients seek neurologic consultation for deteriorating intellectual

capacities, physicians must be cognizant of the full spectrum of

aging-associated cognitive disorders. ========================================

 

Title: Soul of the singing swan: A psychospiritual-Jungian approach to healing

the ruptured mother-child archetype.

Author(s)/Editor(s): Sklover-Filgate, Leesa B.

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 58(12-B) Jun 1998, US: Univ Microfilms International;

1998, 6827

Abstract/Review/Citation: This study enters the phenomenological experience of a

woman of thirty-eight who suffered an amniotic fluid embolism during

childbirth, eight years prior. It resulted in a stroke with brain stem,

frontal lobe, bilateral damage. Quadraplegia and dysphagia (difficulty

swallowing) were cause for placement in a geriatric facility of a major

medical hospital. Rehabilitation for five years proved unsuccessful. After

years of traditional treatment geared towards stabilization, the study

introduced a psychospiritual psychotherapy, longterm, frequent process with

clinical behavioral therapies both of a verbal and non-verbal nature. An

analytic/existential theory base, helped make meaning out of existence, after

the rupturing of the mother/child archetype. Pessimism, inherent in treating

the neurologically impaired with psychotherapy, was confronted with a process

called 'neuropsychotherapy' that suggests true healing occurs through

interpersonal relationship rather than protocol. The case study focused on the

archetypal dynamic between therapist and patient. The process examined,

inspired the making of meaning out of trauma, as well as lessened depression,

evidenced through Becks, Hamilton and verbal assessment. ========================================

 

Title: Head injury and the risk of Alzheimer's disease: A case-control study.

Author(s)/Editor(s): Salib, Emad; Hillier, Valerie

Source/Citation: International Journal of Geriatric Psychiatry; Vol 12(3) Mar

1997, US: John Wiley & Sons Inc; 1997, 363-368

Abstract/Review/Citation: Examined 198 Alzheimer's disease (AD) Ss (mean age 77

yrs), 164 Ss with other dementias (mean age 75 yrs), and 176 Ss with no

dementia (mean age 73 yrs) to assess the reported association between head

injury and risk for AD and other dementias. Ss participated in a structured

interview to assess their history of head injury. Results confirm a positive

association between reported head injury and AD as well as non-Alzheimer type

dementia. Head trauma did not appear to be a specific risk for AD as

previously claimed. In addition, the association was significantly modified by

sex. There was no evidence found supporting an association with other risk

factors.

========================================

 

Title: Media triggers of post-traumatic stress disorder 50 years after the

Second World War.

Author(s)/Editor(s): Hilton, Claire

Source/Citation: International Journal of Geriatric Psychiatry; Vol 12(8) Aug

1997, US: John Wiley & Sons Inc; 1997, 862-867

Abstract/Review/Citation: Posttraumatic stress disorder (PTSD) may present many

years after the original trauma. The case studies of 2 elderly male patients

(aged 72 and 76 yrs) are presented to illustrate this later appearance of

PTSD. Both patients had experienced life-threatening combat situations and

witnessed intense suffering during WWII. Marked distress was triggered by the

media commemorating the 50th anniversary of the end of the war. PTSD patients

often avoid talking of their traumatic experiences because of associated

distress. Without taking a military and trauma history from elderly patients

the diagnosis is likely to be missed. ========================================

 

Title: American Psychiatric Press review of psychiatry, Vol. 16.

Author(s)/Editor(s): Dickstein, Leah J.; Riba, Michelle B.; Oldham, John M.

Source/Citation: Washington, DC, US: American Psychiatric Press, Inc; 1997,

(lxvii, 824) American Psychiatric Press review of psychiatry, Vol. 16.

Abstract/Review/Citation: In the 16th volume of this psychiatric reference

series, more than 40 internationally and nationally recognized experts

describe and evaluate the latest research, treatment, and diagnostic advances

in the areas of cognitive therapy, repressed memories, obsessive-compulsive

disorder, psychopharmacology across the life span, and psychological and

biological testing issues for psychiatrists.  This volume also includes a

section devoted to the use of computers in clinical work that challenges

readers to consider how computers can be incorporated into patient care as we

approach the 21st century.

Notes/Comments: Contributors Foreword to American Psychiatric Press Review of Psychiatry, Volume 16 [by] Leah J. Dickstein, Michelle B. Riba and John M. Oldham Section I: Cognitive therapy Cognitive therapy for anxiety disorders David M. Clark and Adrian Wells Cognitive-behavioral therapy for substance abuse disorders Michael E. Thase Cognitive approaches to personality disorders Judith S. Beck

Cognitive-behavioral treatment of eating disorders James E. Mitchell and Carol

B. Peterson Cognitive therapy for chronic and severe mental disorders Jan

Scott and Jesse H. Wright Section II: Repressed memories Trauma and memory

Lisa D. Butler and David Spiegel Memory, repression, and abuse: Recovered

memory and confident reporting of the personal past Kevin M. McConkey

Intentional forgetting and voluntary thought suppression: Two potential

methods for coping with childhood trauma Wilma Koutstaal and Daniel L.

Schacter Perspectives on adult memories of childhood sexual abuse: A research

review Linda M. Williams and Victoria L. Banyard Repressed memories in

patients with dissociative disorder: Literature review, controlled study, and

treatment recommendations Philip M. Coons, Elizabeth S. Bowman and Victor

Milstein Section III: Obsessive-compulsive disorder across the life cycle

Obsessive-compulsive disorder in children and adolescents Joseph V. Penn, John

March and Henrietta L. Leonard Obsessive-compulsive disorder in adults Michele

T. Pato and Carlos N. Pato Obsessive-compulsive disorder in later life C. Alec

Pollard, Cheryl N. Carmin and Raymond Ownby Course of illness in

obsessive-compulsive disorder Jane Eisen and Gail Steketee

Obsessive-compulsive disorder in pregnancy and the puerperium Susan F. Diaz,

Lynn R. Grush, Deborah A. Sichel and Lee S. Cohen Section IV:

Psychopharmacology across the life span Psychopharmacological treatment of

psychotic disorders across the life span Paul E. Keck, Jr. and Stephen M.

Strakowski Psychopharmacological treatment of bipolar disorder across the life

span Susan L. McElroy and Elizabeth Weller Pharmacotherapy of

attention-deficit/hyperactivity disorder: A life span perspective Thomas

Spencer, Joseph Biederman and Timothy Wilens Child and adolescent

psychopharmacology Scott A. West Overview of geriatric psychopharmacology

Andrew Satlin and Charles Wasserman Section V: Psychological and biological

assessment at the turn of the century The laboratory in clinical psychiatry

Philip G. Janicak and Elizabeth A. Winans Psychological assessment in a

managed care climate: The neuropsychological evaluation Steven Mattis and

Barbara C. Wilson Guidelines for selecting psychological instruments for

treatment outcome assessment Frederick L. Newman and Daniel Carpenter

Performance measurement in healthcare delivery systems Naakesh A. Dewan and

Daniel Carpenter Section VI: Computers, the patient, and the psychiatrist

Computers and patient care Zebulon Taintor, Marc Schwartz and Marvin Miller

Using the internet Bertram Warren, Thomas Kramer, Steven E. Hyler and Robert

Kennedy 2005: Information technology impacts psychiatry Norman Alessi, Milton

Huang and Paul Quinlan Afterword to American Psychiatric Press Review of

Psychiatry, Volume 16 [by] Leah J. Dickstein, Michelle B. Riba and John M.

Oldham Index research & treatment & diagnostic advances in cognitive

therapy & repressed memories & obsessive-compulsive disorder &

psychopharmacology & testing issues for psychiatrists & clinical use of computers

========================================

 

Title: Neurobiological perspectives on trauma and aging.

Author(s)/Editor(s): Bergherr, Theresa; Bremner, J. Douglas; Southwick, Steven M.; Charney, Dennis S.; Krystal, John H.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 27-59

Abstract/Review/Citation: Notes that neurobiological perspectives may help to

integrate a diversity of clinical findings regarding aging trauma survivors,

to inform considerations about the course of posttraumatic stress disorder

(PTSD), and to suggest new avenues for treatment. This article begins with a

review of epidemiological and clinical data regarding the long-term course of

PTSD. The authors then focus on 2 aspects of the emerging neurobiology of PTSD

that appear to be relevant to the course of this disorder: alterations in the

regulation of the hypothalamo-pituitary-adrenal-axis and in noradrenergic

systems. In doing so, they consider advances from neuroendocrinology,

psychopharmacology, and brain imaging studies. Prognostic and treatment issues

raised in the process of integrating neurobiological and clinical findings are

considered.

========================================

 

Title: Late life effects of trauma: Adult catastrophic and infantile type.

Author(s)/Editor(s): Krystal, Henry

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 61-82

Abstract/Review/Citation: Presents the author's conceptualizaiton of adult

catastrophic trauma vs infantile trauma, as well as data from a 50-yr followup

of the emotional trauma of 62 Holocaust survivors. The author posits that the

adult traumatic process starts with basically the same point that Freud made

in 1926: "the essence and meaning" of the traumatic situation is

"the subject's estimation of his own strength <--p<--p . and his

admission of helplessness in the face of it." Confrontation with

avoidable or manageable danger evokes fear. The discovery that one is helpless

in the face of an unavoidable danger is reacted to with a paralyzing affect

which M. Stern (1951, 1968) called "catatanoid reaction." This

affect initiates the traumatic process. In contrast, the infantile (but not

childhood) traumatic state is initiated by the infantile affect precursors. 

If empathic mothering is not restored quickly, failure to thrive, hospitalism,

or maramus will set in. If the infant does not die of it, he or she will, with

any significant duration of the early disaster, have some of the same sequels

as adults. From the followup of Holocaust survivors, the patients were able to

describe their sleeping disturbances, multiple pains derived from a number of

sources, and a variety of psychosomatic diseases. ========================================

 

Title: "Late life effects of trauma": Discussion.

Author(s)/Editor(s): Herzog, James M.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 83-90

Abstract/Review/Citation: Comments on H. Krystal's (1997) conceptualization of

the differences between infantile and adult-onset catastrophic trauma. Herzog

blurs somewhat this distinction in terms of ongoing mechanisms by which the

individual manages and requires comanagement of overwhelming exigencies and

circumstances of internal and external danger. The questions of affect

tolerance, play capacity, and the nature of accompaniment and protection are

central to this discussion. The model that Herzog proposes in response to

Krystal acknowledges that intrapsychic as well as interactive catastrophe has

occurred and that attempts at restitution and repair are continuous. ========================================

 

Title: A life-span perspective on the effects of military service.

Author(s)/Editor(s): Spiro, Avron III; Schnurr, Paula P.; Aldwin, Carolyn M.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 91-128

Abstract/Review/Citation: Proposes the adoption of a life-span perspective on

the effects of military service on socioeconomic, psychological, and health

outcomes. Using data from community-residing men participating in the

longitudinal Normative Aging Study (NAS), most of whom happened to be

veterans, the authors examined 3 developmental issues. These issues relate to

the hypothesis that military service has effects on health that might be

mistaken for the effects of aging. Of the 1,802 men from the original NAS

panel who were still living in 1995, 86% were still participating. The 1st

question was whether measures developed to assess posttraumatic stress

disorder (PTSD) in younger Vietnam veterans are useful for older veterans.

Should the same cut-off scores be used on these questionnaires, regardless of

age, to make the putative diagnosis of PTSD? If one assumes that these

measures are valid for older veterans, the present results demonstrate the

existence of PTSD among older veterans, and that its current prevalence is

related to combat exposure. The remaining issues relate to changes in distress

(i.e., PTSD) over time in response to trauma (i.e., combat exposure), and the

long-term effects of military service on health outcomes, considering mental

and physical health and health care utilization. ========================================

 

Title: Biopsychosocial trauma and the urban elderly.

Author(s)/Editor(s): Lightfoot, Orlando B.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 175-192

Abstract/Review/Citation: The urban environment is an appropriate setting to

view the dynamic interaction of biopsychosocial factors in the lives of a

diverse group of elderly individuals. The impact of potentially traumatic

events is important to recognize and understand. The psychiatrist has a

definite role as a member of a closely coordinated multidisciplinary team.

Family member of traumatized patents are a vibrant force in the life of an

identified patient, and they interact intimately with the patient and

caregivers. Case examples of both patients and caregivers are presented.

========================================

 

Title: Victims or survivors? A three-part approach to working with older adults

in disaster.

Author(s)/Editor(s): Massey, Barbara A.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 193-202

Abstract/Review/Citation: Outlines a 3-part approach for professional caregivers

working with older adults in a disaster: a description of the impact of losses

and trauma; assessment of the signs and symptoms of loss and trauma; and

interventions to help older survivors. These approaches will help professional

caregivers allay the fears and prevent posttraumatic stress which can shorten

the life of older adults in a disaster. ========================================

 

Title: Survivors: A review of the late-life effects of prior psychological

trauma.

Author(s)/Editor(s): Sadavoy, Joel

Source/Citation: American Journal of Geriatric Psychiatry; Vol 5(4) Fal 1997,

US: American Psychiatric Press Inc; 1997, 287-301

Abstract/Review/Citation: Reviews the literature on the epidemiology, symptom

picture, and treatment of elderly patients who have encountered serious

psychological trauma earlier in life. Data are predominantly derived from

studies of aging Holocaust survivors and combat veterans from World War II,

the Korean Conflict, and Vietnam. Results show that survivor syndromes persist

into old age, but patterns of expression vary. Holocaust survivors appear to

have adapted well to instrumental aspects of life, whereas combat warriors may

show less functional life-adaptation. Persisting symptoms in all groups

include marked disruptions of sleep and dreaming, intrusive memories,

impairment of trust, avoidance of stressors, and heightened vulnerability to

various types of age-associated retraumatization. There is a deficiency of

controlled treatment studies of traumatized elderly patients, but successful

group, individual, and family clinical interventions have been described.

========================================

 

Title: Subclinical stress responses in noncombatants.

Author(s)/Editor(s): Dobson, Matthew; Marshall, Richard P.; Grayson, David A.

Source/Citation: Journal of Nervous & Mental Disease; Vol 184(7) Jul 1996,

US: Lippincott Williams & Wilkins; 1996, 437-439

Abstract/Review/Citation: Highlights the significance of subclinical stress

responses among noncombatants in a war zone. The authors present case reports

of 2 male veterans, 43 and 62 yrs old, who experienced symptoms as a

consequence of their exposure to the war-zone experience rather than in the

wake of a specific traumatic event. The value of current prevention and

trauma-based treatment strategies for this group of the veteran population is

called into question.

========================================

 

Title: The stressor criterion and diagnosing posttraumatic stress disorder in a

legal context.

Author(s)/Editor(s): Dobson, Matthew; Marshall, Richard P.

Source/Citation: Australian Psychologist; Vol 31(3) Nov 1996, Australia:

Australian Psychological Society; 1996, 219-223

Abstract/Review/Citation: R. A. Bryant (see record 1996-93838-006) outlined a

case where an applicant claimed to be suffering from posttraumatic stress

disorder (PTSD) following exposure to atomic testing. In his paper, Bryant

discusses the legal definition of a stressor, highlighting the ambiguity which

remains in the Mental Disorders-IV (DSM-IV) definition of the stressor

criterion. This comment does not question Bryant's argument concerning the

ambiguity of the stressor criterion, but questions the view that there might

be some way of objectifying the definition of a stressor in the diagnosis of

PTSD, thereby standardizing the diagnosis. The authors' perspective on the

PTSD diagnosis is biased by their experience as clinicians and researchers in

the field of war-related trauma. Although PTSD has been conceptualized as an

anxiety reaction that follows in the wake of exposure to an extreme event,

there may not be a discrete class of stressors that cause PTSD. In supporting

this view, it is argued that the etiology of PTSD is multidimensional. It

follows that PTSD cannot be understood in terms of a cause-effect type

relationship between the stressor and symptoms, as is required for the

assessment of compensation/litigation claims in the courtroom setting.

========================================

 

Title: Memory and attention in the healthy elderly.

Author(s)/Editor(s): Orchard, Rebecca Jean

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 55(9-B) Mar 1995, US: Univ. Microfilms International;

1995, 4165

Abstract/Review/Citation: The 'normal aging process,' as traditionally

conceptualized, presumes cognitive decrements with age, independent of

pathology. However, this expectation is based upon results of studies whose

samples were inadequately screened for health status. Normative samples in

geriatric neuropsychology research, for example, were screened for obvious

factors such as history of head trauma and neurological disorders, but not for

chronic systemic illnesses such as diabetes and hypertension, which we now

realize adversely affect cognitive functioning. This study investigated the

influence of age and health status on verbal and visual memory and attention.

The objective was to select subjects resembling participants in normative

studies, and to contrast the genuinely healthy component with the

'contaminants.' A rigorous and detailed self-report of health status plus a

standard neurological examination were used to screen and divide subjects into

two health status groups: normal and super healthy. It was speculated that the

strong effect of age on memory and attention commonly found among the elderly

would be diminished with more restrictive control over health status.

Specifically, age was predicted to significantly affect performance in the

less healthy group alone. Also, the super healthy were predicted to outperform

the normals, regardless of age. Contrary to prediction, the super healthy did

not outperform the normals when scores were adjusted for three covariates:

vocabulary, education, and depression. (However, in exploratory analyses in

which covariates were dropped, the super healthy did outperform the normals on

verbal memory tests.) Likewise contrary to prediction, there was no evidence

of an age by health status interaction, with or without covariates. While

these negative results fail to challenge traditional findings, a lack of

findings regarding age in the current study is surprising, and may indicate

the value of rigorous screening in studies of this type.

========================================

 

Title: Listening with different ears:  Counseling people over sixty.

Author(s)/Editor(s): Warnick, James

Source/Citation: Fort Bragg, CA, US: QED Press; 1995, (vi, 215)

Abstract/Review/Citation: Warnick demonstrates effective and creative techniques

the counselor can use [when working with elderly persons]. He indicates what

works and what doesn't and provides a refreshing and original slant on the

subject. He shows in a practical, optimistic way that working with

"third-age" people . . . can be extremely rewarding. [This book]

challenges outdated beliefs about aging and explains how to help older people

cope with transitions, trauma and stress; offers approaches and solutions to

12 major problems that confront older people; contains . . . case histories

and suggestions for treatment; melds several therapeutic approaches to create

a warm, caring counseling relationship while offering a concrete,

goal-oriented approach to problem solving.  [This book is for] anyone who

works with seniors in a helping capacity, including counselors, therapists,

senior center outreach workers, family physicians, psychologists, clergy,

long-term care professionals, educators and health workers. . . . It is also

[a] supplemental text for social service, gerontological and social psychology

courses.

Notes/Comments:  Preface Section one: Introducing the third age Why

counsel the third age? Pressures of the third age Counseling mechanics

Considerations when dealing with third age people Section two: Major problems

Anxiety, depression, and abnormal grief Retirement and independent living

Health problems and pain management Marital, relationship, and personality

problems Lifestyle dissatisfaction, lifelong problems, and substance abuse

Dementia and late onset paranoia Suicide, terminal illness, and traumatic

experiences Ten case studies Section three: Solutions Making it work

Appendices Assessment aid The initial session Brief therapy Cognitive therapy

aids Helping clients understand themselves Supportive therapy aids Relaxation

aids Psychiatric medication review Resources Index techniques for counseling

& coping with transitions & trauma & stress, elderly

========================================

 

Title: Childhood abuse history in older women with panic disorder.

Author(s)/Editor(s): Sheikh, Javaid I.; Swales, Pamela J.; Kravitz, Jean; Bail,

Gregory; et al

Source/Citation: American Journal of Geriatric Psychiatry; Vol 2(1) Win 1994,

US: American Psychiatric Press Inc; 1994, 75-77

Abstract/Review/Citation: 17 women (aged 55-73 yrs) participating in a clinical

trial for older panic disorder patients were administered the Childhood Trauma

Questionnaire by M. Folstein et al (see record 1976-20785-001). Seven Ss

reported histories of sexual abuse. Physical abuse was reported by lO Ss,

including 6 of the 7 who also reported sexual abuse. The data raise questions

regarding the possible contributory role of childhood trauma in some panic

disorder patients.

========================================

 

Title: Handbook of play therapy, Vol. 2:  Advances and innovations.

Author(s)/Editor(s): O'Connor, Kevin J.; Schaefer, Charles E.

Source/Citation: New York, NY: John Wiley & Sons; 1994, (xiv, 447) Wiley

series on personality processes.

Abstract/Review/Citation: "The Handbook of Play Therapy, Volume Two:

Advances and Innovations" considerably expands on the first volume

[published in 1983] by presenting the theoretical, technical, and

methodological advances coming out of this steadily growing field.  Leading

authorities on the various aspects of play therapy [were invited] to write

original chapters presenting the developments that have occurred in the field

since 1983. Material [included] is interdisciplinary in approach, eclectic in

theory, and comprehensive in scope.  Psychiatrists, psychologists, social

workers, nurses, and counselors at all levels of training and experience will

find this [handbook] informative, thought provoking, and clinically useful.

Notes/Comments: Print (Paper) Human 10 Childhood (birth-12 yrs) 100 Part 1:

Theoretical approaches to the practice of play therapy Adlerian play therapy 

Terry Kottman Time-limited play therapy  Richard E. Sloves and Karen Belinger

Peterlin Ecosystemic play therapy  Kevin J. O'Connor Dynamic play therapy:

Expressive play intervention with families  Steven Harvey Cognitive-behavioral

play therapy  Susan M. Knell Gestalt play therapy  Violet Oaklander Part 2:

Developmental adaptations of play therapy Adolescent theraplay  Terrence J.

Koller The use of play therapy with adults  Diane E. Frey Geriatric theraplay 

Sandra Lindaman and Debra Haldeman Part 3: Play therapy techniques and methods

The Erica Method of sand play diagnosis and assessment  Margareta Sjolund and

Charles E. Schaefer Jungian play therapy techniques  Gisela De Domenico The

Good Feeling-Bad Feeling Game  Sue Ammen Part 4: Play therapy applications

Play therapy for psychic trauma in children  Charles E. Schaefer Play

diagnosis and play therapy with child victims of incest  Jamshid A. Marvasti

Play therapy with mentally retarded clients  Joop Hellendoorn Filial therapy

for adoptive children and parents  Rise Van Fleet Play therapy with children

of alcoholics and addicts  Mary Hammond-Newman A structured activities group

for sexually abused children  Scott J. Van de Putte Author index Subject index

theoretical approaches to & techniques & methods & applications of

play therapy, children, handbook Handbook/Manual/Guide 6000

========================================

 

Title: The interdisciplinary approach to treating the traumatized personality

disordered elderly patient.

Author(s)/Editor(s): Johnson, Susan T.

Source/Citation: Journal of Geriatric Psychiatry; Vol 27(2) 1994, US:

International Universities Press Inc; 1994, 221-240

Abstract/Review/Citation: Contends that assessing the treatment needs of

elderly individuals in community or institutional settings involves taking into

account their psychiatric diagnoses, psychosocial and emotional problems, and

physical illnesses. Two clinical cases of individuals with personality

disorders stemming from childhood trauma illustrate the work of

interdisciplinary team (IT) management in the community and in a residential

setting. Coordination of care was more difficult in the case of the female S

(in her late 70s) treated at home than in the case of the male S (in his

mid-80s) treated in a rest home where the IT was already in place.

========================================

 

Title: Successful treatment with captopril of an elderly man with polydipsia and

hyponatremia.

Author(s)/Editor(s): Tueth, Michael J.; Broderick-Cantwell, John

Source/Citation: Journal of Geriatric Psychiatry & Neurology; Vol 6(2)

Apr-Jun 1993, Canada: Decker Periodicals Inc; 1993, 112-114

Abstract/Review/Citation: Presents a case of a 64-yr-old alcoholic White male

with mild frontal lobe dementia resulting from brain trauma. The S had had at

least 5 episodes of polydipsia associated with hyponatremia, complicated by

seizures. The S was unsuccessfully treated with demeclocycline, then lithium

carbonate; effective treatment was administered in the form of 12.5 mg/day of

captopril. Within the 1st 15 days of hospitalization, the S's serum sodium

level dropped to the normal range.

========================================

 

Title: Early life trauma, infertility and late life paranoia: A relationship

with post traumatic stress disorder?

Author(s)/Editor(s): Busuttil, Walter; Aquilina, Charles; Busuttil, Angela

Source/Citation: International Journal of Geriatric Psychiatry; Vol 8(8) Aug

1993, US: John Wiley & Sons Inc; 1993, 693-695

Abstract/Review/Citation: Comments on B. S. Gurian's et al article on the possible relationship between late life paranoia and early trauma. This theory is discussed with reference to reports of stress-related disorders in concentration camp survivors from the

1940s-2960s. It is suggested that Gurian's et al Ss may have suffered from

posttraumatic stress disorder

========================================

 

Title: Sexual problems associated with dementia: I. Problems and their

consequences.

Author(s)/Editor(s): Haddad, Peter M.; Benbow, Susan M.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 8(7) Jul

1993, US: John Wiley & Sons Inc; 1993, 547-551

Abstract/Review/Citation: Examines possible reasons for the dearth of research

on sexual problems in elderly demented individuals, outlines the types of

sexual problems associated with dementia, and discusses their consequences.

Reasons for the neglect relate to the fact that noncognitive aspects of

dementia have generally received less attention than cognitive aspects, the

embarrassing nature of the topic, ethical issues, and stereotypes of the

elderly as sexless. Sexual problems consist of those involving an established

partner, those involving a new partner, those independent of a sexual partner

(e.g., sexual acting out, inappropriate sexual talk, and false sexual

allegations), and sexual abuse. Such problems can impair the quality of life

and impair affection and closeness, and may lead to confinement in the home

for the demented individual. Physical trauma may also result.

========================================

 

Title: The dexamethasone suppression test in psychiatric disorders.

Author(s)/Editor(s): Rothschild, Anthony J.

Source/Citation: Psychiatric Annals; Vol 23(12) Dec 1993, US: SLACK Inc; 1993,

662-670

Abstract/Review/Citation: Discusses uses of the dexamethasone suppression test

(DST) in clinical situations pertaining to such conditions as affective

disorders, major depression with psychotic features, geriatric depression, and

dysthymic disorder/borderline personality disorder. Also discussed is the use

of the DST in studying schizophrenia, panic disorder, obsessive-compulsive

disorder, posttraumatic stress disorder (PTSD), and eating disorders. It is

concluded that although the use of the DST in the clinical setting has

decreased, the test may have utility in certain situations, such as the

differentiation of major depression with psychotic features from

schizophrenia. However, it is noted that attempts to correlate abnormalities

observed on administration of the DST (with the exception of psychotic

depression) have met with limited success.

========================================

 

Title: Geriatric issues: Special considerations.

Author(s)/Editor(s): Murphy, Claire; Davidson, Terence M.

Source/Citation: Journal of Head Trauma Rehabilitation; Vol 7(1) Mar 1992, US:

Aspen Publishers Inc; 1992, 76-82

Abstract/Review/Citation: Discusses age-associated losses in the ability to

taste and smell and addresses the effects of trauma-related taste and smell

impairments in the elderly. In such cases, traumatic loss is superimposed on

an already existing loss. Olfactory loss actually contributes more than taste

loss to older people's difficulty with food appreciation. Odor-threshold

sensitivity decreases, odor intensity decreases, and the ability to identify

and remember odors is reduced. Designing appropriate rehabilitation for

geriatric trauma patients with olfaction or gustation impairments is

described.

========================================

 

Title: Late-life paranoia: Possible association with early trauma and

infertility.

Author(s)/Editor(s): Gurian, Bennett S.; Wexler, Debra; Baker, Errol H.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 7(4) Apr

1992, US: John Wiley & Sons Inc; 1992, 277-284

Abstract/Review/Citation: Studied data on 39 persons (aged 60-93 yrs) with

late-life onset of paranoid symptoms. A subset of 9 female Ss met the criteria

for delusional disorder (DD). DD Ss differed significantly from demented and

long-term schizophrenic Ss on a number of variables. Among the DD Ss, (1)

there was only 1 live birth, (2) more than half were refugees or holocaust

survivors, (3) there was an absence of a predicted sensory loss, and (4) the

manifestation of the paranoia was qualitatively different. Discussion

addresses the existence of a late-life delusional state that is neither

schizophrenia nor dementia and indicates that the paranoia in DD Ss cannot be

accounted for exclusively by a social isolation hypothesis. Also considered is

the interaction among early trauma, absence of children, and appearance of

paranoid ideation late in life.

========================================

 

Title: Risk factors for Alzheimer's Disease.

Author(s)/Editor(s): Amaducci, Luigi; Lippi, A.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 7(6) Jun

1992, US: John Wiley & Sons Inc; 1992, 383-388

Abstract/Review/Citation: Discusses some of the possible risk factors in the

development of Alzheimer's disease (AD): age, gender, Down's syndrome in the

S, and a history of dementia in 1st degree relatives. Evidence suggests the

possible role of late maternal age at S's birth and previous depression as

risk factors for AD. Among environmental factors, the role of head trauma is

supported by a number of studies. The relationship between education and brain

function is also discussed. Low education could reduce the margin of brain

reserve to a level at which a limited brain pathology can result in a dementia

syndrome (DS). Also, less educated people may be more exposed to environmental

factors that may lead to a DS.

========================================

 

Title: Alcohol abuse in elderly emergency department patients.

Author(s)/Editor(s): Adams, Wendy L.; Magruder-Habib, Kathryn; Trued, Sally; Broome, Harry L.

Source/Citation: Journal of the American Geriatrics Society; Vol 40(12) Dec

1992, US: Lippincott Williams & Wilkins; 1992, 1236-1240

Abstract/Review/Citation: Investigated the prevalence of alcohol abuse in 205

elderly emergency department (ED) patients (aged 65+ yrs) for various

categories of illness and injury and examined the frequency of detection of

elderly alcohol abusers by ED physicians. The prevalence of lifetime alcohol

abuse was 24%. The prevalence of current alcohol abuse was 14%. There was a

high prevalence among Ss presenting with abdominal problems and a low

prevalence among Ss who presented with falls or other trauma. Physicians

detected only 21% of the current alcohol abusers. Alcohol abuse is prevalent

but not well detected by physicians among elderly ED patients. Alcohol abuse

appears to be less common among elderly trauma patients than their younger

counterparts, but is very common among patients with abdominal problems.

========================================

 

Title: Alzheimer's disease: New insights into an emerging epidemic.

Author(s)/Editor(s): Selkoe, Dennis J.

Source/Citation: Journal of Geriatric Psychiatry; Vol 25(2) 1992, US:

International Universities Press Inc; 1992, 211-227

Abstract/Review/Citation: Emphasizes the clinical approach to the diagnosis and

management of Alzheimer's disease (AD), discusses the definition of dementia,

and reviews the major recent advances that have been made in understanding the

pathogenesis of this disorder. One of the most characteristic clinical

features of AD is its insidious onset and inexorable progression. A careful

history is the most important feature of the clinical evaluation of patients

with suspected AD. In addition to recording the 1st symptoms, examples of

typical errors or confusional episodes, and the approximate rate of

deterioration, the physician must inquire about possible transient ischemic

attacks and minor or major head trauma. Although AD is an emerging epidemic,

there is (at present) no proven effective pharmaceutical agent for its

treatment.

========================================

 

Title: Dementing illness in African American populations: Evaluation and

management for the primary physician.

Author(s)/Editor(s): Baker, F. M.

Source/Citation: Journal of Geriatric Psychiatry; Vol 24(1) 1991, US:

International Universities Press Inc; 1991, 73-91

Abstract/Review/Citation: Reviews the current literature on dementing illness in

older Blacks. Based on the medical problems of the Black community identified

in national studies, the potential for an increased prevalence of alcoholic

dementia, multi-infarct dementia, and acquired immune deficiency syndrome

(AIDS) dementia have been documented. The increased prevalence of head trauma,

particularly in Black males, may result in a high prevalence of clinically

diagnosed Alzheimer's disease. The difficulty of appropriately diagnosing

cognitive impairment in elderly Blacks is addressed. Case histories of a

62-yr-old man and a 78-yr-old woman illustrate the importance of history from

the social networks of elderly Blacks.

========================================

 

Title: Trauma and problems about the cause of death.

Author(s)/Editor(s): Lelie, L. H.

Source/Citation: Nederlands Tijdschrift voor Gerontologie; Vol 8(2) Jun 1977,

88-91

Abstract/Review/Citation: Discusses the process of dying, in which death is seen

as the final stage of a fundamental biological process. Over a period of 10

yrs, 674 patients died in a geriatrics hospital. Of these patients, 45

experienced a trauma 6 mo before their deaths. These traumas are considered to

be the starter of the process of dying. ========================================

 

Title: Somatopsychic disease.

Author(s)/Editor(s): Arce, Luis

Source/Citation: Psychosomatics; Vol. 13(3) May 1972, US: American Psychiatric

Press, Inc.; 1972, 191-196

Abstract/Review/Citation: Presents the concept of "somatopsychic

medicine," as distinguished from "psychosomatic medicine." The

term "somatopsychic illness" is proposed to describe the appearance

of psychological disturbances in patients who have a physical illness. The

most common psychiatric symptoms in somatic illness are discussed, as related

to the cardiac patient, the surgical patient, the trauma patient, the cancer

patient, the medical patient, the chronically ill patient, the geriatric

patient, and the dying patient. Some considerations for management of the

concomitant psychological disturbance are outlined. (27 ref) ========================================

 

Title: Sexual issues of patients with Alzheimer's disease.

Author(s)/Editor(s): Teri, Linda; Reifler, Burton V.

Source/Citation: Medical Aspects of Human Sexuality: Special Issue: The

physician's guide to sexual counseling; Vol 20 Mar 1986, US: Hospital

Publications, Inc.; 1986, 86-91

Abstract/Review/Citation: Discusses sexual functioning and problems of patients

with Alzheimer's disease. Problems range from diminished interest in sex to

inappropriate activity due to confusion. The patient's spouse faces problems

in that the disease-related changes in the patient may impair the healthy

spouse's enjoyment of or desire for sex; stress and fatigue generated by

emotional trauma and pressures of daily activities may greatly reduce his/her

motivation and energy for sexual activity; and feelings of loss, despair,

grief, and depression cause further negative reactions and effects on

sexuality. Management strategies, including medication, can help make the

situation more tolerable.

========================================

 

Title: Remote effects of head trauma.

Author(s)/Editor(s): Mortimer, James A.; Pirozzolo, Francis J.

Source/Citation: Developmental Neuropsychology; Vol 1(3) 1985, US: Lawrence

Erlbaum Assoc; 1985, 215-229

Abstract/Review/Citation: Suggests that new neuropsychological deficits may

emerge months or years after an episode of head trauma. Head injury has been

suggested as a risk factor for several degenerative neurological conditions,

including the punch-drunk syndrome, Alzheimer's disease, Pick's disease,

Parkinson's disease, and Creutzfeldt-Jacob disease. The evidence for an

etiologic role of head trauma in these conditions is reviewed, and possible

mechanisms for the production of delayed neuropsychological deficits are

considered.

========================================

 

Title: Post traumatic changes in perceptions of purpose in life and

three-dimensions of locus of control in stroke and hip surgery patients.

Author(s)/Editor(s): McGraw, Richard M.

Source/Citation: Dissertation Abstracts International; Vol 45(3-B) Sep 1984, US:

Univ. Microfilms International; 1984, 1023 

Abstract: [None]

========================================

 

Title: Alzheimer's disease and critical care: Interactions, implications,

interventions.

Author(s)/Editor(s): Palmer, Mary H.

Source/Citation: Journal of Gerontological Nursing; Vol 9(2) Feb 1983, US:

SLACK, Inc.; 1983, 86-90, 116

Abstract/Review/Citation: Contends that a knowledge of Alzheimer's disease (AD)

and its progression helps the critical care unit (CCU) nurse implement

anticipatory and preventive interactions to promote the quality of life and

maintain the cognitive functions of the patient. Careful planning, open

communication, and awareness of one's own feelings regarding aging and chronic

dementing disorders will minimize trauma to both the nursing staff routine and

to the client while providing superior care tailored to the many challenging

needs AD poses. A case study of a 56-yr old AD female is presented to

illustrate the needs of a patient in a CCU. (39 ref) ========================================

 

Title: Psychotherapy of the elderly: Case #6.

Author(s)/Editor(s): Peck, Arthur

Source/Citation: Journal of Geriatric Psychiatry; Vol 16(1) 1983, US:

International Universities Press Inc; 1983, 73-77

Abstract/Review/Citation: Describes the 20-yr treatment of a 97-yr-old woman who

had been a resident of a home for older persons for 32 yrs. The S's history

included an unusual upbringing, the experience of being a refugee from the

Nazis, and the trauma of her husband's suicide. The S was initially referred

for anxiety following after cholecystectomy. 10-25 min biweekly sessions with

the author and a volunteer provided support and helped her adapt to crises

that included an above-the-knee amputation, diabetic coma, and loss of friends

and staff.

========================================

 

Title: Words before we go: The experience of Holocaust and its effect on

communication in the aging survivor.

Author(s)/Editor(s): Merowitz, Martin

Source/Citation: Journal of Geriatric Psychiatry; Vol 14(2) 1981, US:

International Universities Press Inc; 1981, 241-244

Abstract/Review/Citation: Argues that the Holocaust experience may disturb (1)

the biological apparatus necessary for communication of an affective

experience (as in massive psychic trauma that correlates with brain damage),

(2) social labeling and learning, and (3) the reception of the message by the

learner. Words can be used to tame the memory of the raw experience and to aid

in grieving. Sometimes the difficulty of mourning is shown in the survivor's

insistence on bearing witness to the Holocaust experience. At the end of old

age, when there is less time to resolve this experience, the final task may be

renunciation. (1 ref)

========================================

 

Title: Integration and self-healing in posttraumatic states.

Author(s)/Editor(s): Krystal, Henry

Source/Citation: Journal of Geriatric Psychiatry; Vol 14(2) 1981, US:

International Universities Press Inc; 1981, 165-189

Abstract/Review/Citation: In follow-up studies of Holocaust survivors, the

author has found a high rate of psychosomatic disease, especially alexithymia

accompanied by anhedonia. This can be traced to adult catastrophic psychic

trauma brought on by the unavoidable danger of the Holocaust experience and

causing a change in the affective state from anxiety to a pattern of

surrender. Simultaneously, a numbing process blocks all pain and leads to a

progressive constriction of cognitive processes, including memory and problem

solving. The aftereffects of this trauma represent a continuation of the

traumatic experience and consist of continued cognitive restriction, episodic

"freezing" under stress, and pseudophobia. Holocaust survivors who

are unable to work through their hatred and past memories and to integrate

this past are substituting moral judgment for self-healing. Survivors unable

to integrate can often not complete analysis because they are unable to

complete the necessary mourning process. Instead, they handle their problems

by a constriction of interest, by avoidance of both pleasure and excitement.

(62 ref)

========================================

 

Title: Reconciliation between the generations: A last chance.

Author(s)/Editor(s): Kahana, Ralph J.

Source/Citation: Journal of Geriatric Psychiatry; Vol 14(2) 1981, US:

International Universities Press Inc; 1981, 225-239

Abstract/Review/Citation: Discusses a son's striving for reconciliation with his

father, a survivor of the Holocaust. When the 30-yr-old patient entered

psychoanalysis, he did not initially mention his parents' Holocaust experience

as constituting any particular problem. However, it became apparent that the

father's uncommunicative behavior and seeming disinterest in the son caused

the son numerous emotional disturbances in adulthood. While the children of

Holocaust survivors are usually very much wanted by their parents, the parents

may unknowingly transmit their own trauma to their children through

overprotectiveness or paranoia. Some members of the 2nd generation show

symptoms and character traits as though they themselves had lived through the

Holocaust. (11 ref)

========================================

 

Title: Personality variables in the identification of retirement trauma.

Author(s)/Editor(s): Bannon, Laurence W.

Source/Citation: Dissertation Abstracts International; Vol 38(11-B) May 1978,

US: Univ. Microfilms International; 1978, 5555 

Abstract: [None]

========================================

 

Title: The differential effects of relocation on nursing home patients.

Author(s)/Editor(s): Pino, Christopher J.; Rosica, Lenore M.; Carter, Thomas J.

Source/Citation: Gerontologist; Vol 18(2) Apr 1978, US: Gerontological Society

of America; 1978, 167-172

Abstract/Review/Citation: Four groups of 25 institutionalized aged patients each

were matched by age, sex, medical diagnosis, and overall level of functioning

(PULSES). Pre- and posttest measurements on the Activities of Daily Living

scale, Raven Progressive Matrices, Mental Status Questionnaire, Life

Satisfaction Scale, and Personality Adjustment Scale were administered to

determine the effects of relocation on 3 experimental populations in contrast

to a stationary control group. Analysis of mortality and release rates

suggests that PULSES is effective in predicting an individual's ability to

withstand the trauma of relocation. Factors related to successful adjustment

to a new nursing home were isolated. (18 ref) ========================================

 

Title: The pathology of the aging human nervous system.

Author(s)/Editor(s): Duckett, Serge

Source/Citation: Philadelphia, PA, US: Lea & Febiger; 1991, (xix, 505)

Abstract/Review/Citation: This comprehensive review of the pathology of

neurological diseases which afflict humans 65 years of age and older reflects

the revolutionary improvements in diagnostic modalities, including immunology,

genetics, biochemistry, and radiology. No other text offers such contemporary

and comprehensive coverage of the patholgoy of the aging human central,

peripheral, and sympathetic nervous system.  Following an introductory

chapter on the social, economic, and creative forces of aging individuals,

chapters provide a detailed and up-to-the-minute review of the dementias,

highlighting the clinicopathologic characteristics of each disease. An entire

chapter is devoted to Alzheimer's disease, considering gross examination of

the brain, neuronal loss, senile changes, and neurochemical deficits.

Throughout the text, citation of neuro-imaging studies assist the reader in

distinguishing changes related to the aging human nervous system. Information

from the frontiers of research has been incorporated in a section devoted to

genetic and immunologic disorders, with unique coverage of spinocerebellar

system degenerations, neoplasms affecting the nervous system of the elderly

and drugs and the aging human brain. This indispensable reference guides the

clinician to successful treatment and management of the aging human nervous

system by presenting the necessary tools for diagnosing the condition,

detailing the expected prognosis, and providing indications for treatment

where appropriate.

Notes/Comments:  The normal aging human brain  Serge Duckett Vascular

diseases  Harry V. Vinters and Vei H. Mah Dementia  Serge Brion, Jacqueline

Mikol, Joel Plas and Anca Bereanu Alzheimer's disease  Jean-Jacques Hauw,

Charles Duyckaerts and Pia Delaere Spinocerebellar system degenerations  Joo

Ho Sung and Ronald C. Kim Motor system degenerations  Ronald C. Kim and Joo Ho

Sung Huntington's disease  Ronald C. Kim and Joo Ho Sung Parkinson's disease

and Parkinsonian syndrome  Francoise Gray, Jacques Poirier and Francesco

Scaravilli Nutritional disorders and alcoholism  Serge Duckett and Scott

Schoedler Neoplasms affecting the nervous system of the elderly  Ellsworth C.

Alvord, Jr. and Cheng-Mei Shaw Immunologic diseases  J. Bruce Smith and

Michael E. Shy Demyelinating disorders of the aged brain  Robert L. Knobler

Genetic geriatric neuropathology  Serge Duckett, Samuel H. Markind, Timothy

Block and Rudolph E. Tanzi Central nervous system trauma in the elderly 

Everett J. Austin Infection of the central nervous system in the elderly  Mark

Stacy and David Roeltgen Peripheral neuropathy  Claude Vital and Anne Vital

Pathology of the sympathetic nervous system  Robert E. Schmidt Drugs and the

aging brain  Michael Gordon and Harold G. Preiksaitis Clinical neurochemistry

of brain disorders in aging  Christer Alling Neuroradiology  O. F. Agee Index

professional text which reviews the pathology of neurological diseases of the

central, peripheral, & sympathetics nervous system which afflict humans 65

years of age & older

========================================

 

Title: Relocation trauma: Relationship between social support and depression,

morbidity and mortality.

Author(s)/Editor(s): Williams, Sharon K.

Source/Citation: Dissertation Abstracts International; Vol 52(6-B) Dec 1991, US:

Univ. Microfilms International; 1991, 3313 

Abstract: [None]

========================================

 

Title: Etiologia de las crisis epilepticas en el paciente geriatrico. Resultados

de un estudio retrospectivo./ Etiology of epileptic crises in the geriatric

patient. Results of a retrospective study.

Author(s)/Editor(s): Morlan Gracia, L.; Balseiro Gomez, J.; Gil-Nagel Rein, A.; Gonzalez Guerrero, J. L.; et al

Source/Citation: Archivos de Neurobiologia; Vol 54(4) Jul-Aug 1991, Spain:

Fundacion Archivos de Neurobiologia; 1991, 135-139

Abstract/Review/Citation: Conducted a study of the etiology of seizures in 46

patients who developed seizures after age 65. The most frequent cause was

cerebrovascular disease (41.3% of all cases). Clinical diagnosis of

Alzheimer's disease was made in 5 patients (10.8%). Other etiologies were

metabolic encephalopathies (6.5%), craniocerebral trauma (4.3%), and glioma

(2.1%). The etiology of seizures remained unknown in 34.7% of Ss. Seizure

types were generalized tonic-clonic (48%) and partial or partial secondary

generalized (44.1%). The role of Alzheimer's disease in late onset seizures

has not been sufficiently examined in previous studies. A well-designed

prospective study is necessary to establish the frequency of causes of

seizures in the elderly. (English abstact). ========================================

 

Title: Osteoporosis with pathologic hip fractures in major depression.

Author(s)/Editor(s): Van Vort, Walter B.; Rubenstein, Margot; Rose, Robert P.

Source/Citation: Journal of Geriatric Psychiatry & Neurology; Vol 3(1)

Jan-Mar 1990, Canada: Decker Periodicals Inc; 1990, 10-12

Abstract/Review/Citation: Describes cases of major depression in 3 women (aged

65-78 yrs) in which the hospital course was complicated by pathologic hip

fractures secondary to osteoporosis. There was an absence of fall or trauma as

a proximate cause of the fractures in all 3 Ss. Hip fractures were

spontaneous, reflecting advanced bone disease. Biological consequences of

depression and movement during hospital treatment are discussed as possible

mediators of osteoporotic morbidity. ========================================

 

Title: Who's knocking now? New clientele for nursing homes.

Author(s)/Editor(s): Lusk, Patricia

Source/Citation: Journal of Gerontological Nursing; Vol 16(6) Jun 1990, US:

SLACK, Inc.; 1990, 8-11

Abstract/Review/Citation: New clientele being introduced to nursing homes

include chronically mentally ill people, survivors of head trauma, terminally

ill people with acquired immune deficiency syndrome (AIDS), brain-damaged drug

abusers, and developmentally disabled and retarded adults. Causes for this

trend are discussed.

========================================

 

Title: Drug treatments for cognitive impairment due to ageing and disease:

Current and future strategies.

Author(s)/Editor(s): Dowson, Jonathan H.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 4(6) Nov-Dec

1989, US: John Wiley & Sons Inc; 1989, 345-353

Abstract/Review/Citation: Reviews research on drugs, including

dihydroergotoxine, bufluomedil, paracetam, and centrophenoxine, that have been

claimed to have a beneficial effect on cognitive impairment in the aged and in

various diseases. Future strategies will be directed toward reducing the

adverse effects of the aging process and neutralizing the pathogenic

mechanisms related to genetic factors, infections, toxins, trauma, anoxia, and

diet. Prophylactic administration of drugs with antioxidant activity can

reduce adverse effects of the production of "free radicals" in animal models.

Other drugs with therapeutic potential include antagonists of

the excitatory effects of glutamate and aspartate. ========================================

 

Title: Tratamento psicofarmacologico do paciente idoso agitado./

Psychopharmacologic treatment of agitated elderly patients.

Author(s)/Editor(s): Salim, Jair

Source/Citation: Jornal Brasileiro de Psiquiatria; Vol 38(5) Sep-Oct 1989,

Brazil: Editora Cientifica Nacional Ltda.; 1989, 285-288

Abstract/Review/Citation: Discusses the diagnosis, etiology, and treatment of

psychomotor agitation among elderly patients. Causes of psychomotor agitation

among elderly Ss include psychoorganic syndromes such as Korsakoff's syndrome,

endogenous psychosis, symptomatic psychoses, and acute confusional states;

intrinsic and extrinsic cerebral factors; and exogenous factors such as trauma

and use or withdrawal from alcohol or other medications. Factors that affect

the pharmacokinetics and pharmacodynamics of medications used to treat

psychomotor agitation and suggestions for managing these patients are

discussed. Among drugs recommended for treating psychomotor agitation in

elderly patients are antipsychotics, anxiolytics (benzodiazepines),

antidepressants, muscle relaxants, antihistamines, phytosedatives, and

antiepileptics. Recommended dosages of these drugs are listed. (English

abstract)

========================================

 

Title: Treating the elderly with psychotherapy: The scope for change in later

life.

Author(s)/Editor(s): Sadavoy, Joel; Leszcz, Molyn

Source/Citation: Madison, CT, US: International Universities Press, Inc; 1987,

(xxiv, 366)

Abstract/Review/Citation: The book focuses on a spectrum of disorders and

difficulties in both ambulatory, relatively intact individuals, and

institutionalized and more severely impaired patients.  A special emphasis has

been placed on the understanding and management of the problems of the

interdisciplinary team in dealing with the difficult elderly person who evokes

difficult transference-countertransference reactions within certain milieus. 

General psychiatrists dealing with the elderly and those who use

psychotherapeutic approaches, psychogeriatric consultants, as well as social

workers, nurses, psychologists, and other members of the health care team may

find the book of value.  The book is divided into three main sections. 

The first deals with general psychodynamic issues, providing an overview of

theoretical, psychodynamic, and psychotherapeutic principles in the treatment

of the aged patient.  Part II Deals more specifically with four aspects of

psychopathology which are especially relevant to the elderly: paranoid

disorders, the effect of massive psychic trauma, the exaggerated helplessness

syndrome, and character pathology. The final section of the book is

devoted to specific approaches to treatment.  We hope this volume achieves

its purpose of aiding those who are seriously engaged in treating the elderly,

by demonstrating psychodynamic and psychotherapeutic theories and techniques

which can be practically applied on a clinical level.

Notes/Comments:  Foreword [by] Irvin D. Yalom Preface Acknowledgments

Contributors Part I  General psychodynamic perspectives The

mourning-liberation process: Ideas on the inner life of the older adult 

George H. Pollock The aged in psychotherapy: Psychodynamic contributions to

the treatment process  Jerome M. Grunes Reflections on psychotherapy with the

elderly  Martin A. Berezin Part II  Manifestations of psychopathology

Psychodynamics of paranoid phenomena in the aged  Adrian Verwoerdt The impact

of massive psychic trauma and the capacity to grieve effectively: Later life

sequelae  Henry Krystal Exaggerated helplessness syndrome  Lawrence Breslau

Character disorders in the elderly: An overview  Joel Sadavoy Part III

Specific psychotherapeutic modalities Geriatric psychotherapy: Beyond crisis

management  Ralph J. Kahana Brief psychotherapy with the elderly: A study of

process and outcome  Lawrence W. Lazarus and Lesley Groves The whole

grandfather: An intergenerational approach to family therapy  Etta Ginsberg

McEwan Group psychotherapy with the elderly  Molyn Leszcz Name index Subject

index

========================================

 

Title: Radial nerve palsy in nursing home patients: Association with immobility

and haloperidol.

Author(s)/Editor(s): Sloane, Philip D.; McLeod, Melissa M.

Source/Citation: Journal of the American Geriatrics Society; Vol 35(5) May 1987,

US: Lippincott Williams & Wilkins; 1987, 465-466

Abstract/Review/Citation: Discusses nerve compression injuries that are

associated with prolonged or repeated trauma at sites where nerves are

anatomically exposed and reports cases of radial nerve compression in 3

nursing home residents (aged 81-98 yrs) with dementia, schizophrenia, and

hypothyroidism; probable Alzheimer's disease; and a mixed diagnosis that

included dementia. Causes of radial nerve damage are suggested, and

suggestions for avoiding these problems are offered.

========================================

 

Title: Geriatric psychiatry: A model for evaluation.

Author(s)/Editor(s): Baker, F. M.

Source/Citation: Journal of the National Medical Association; Vol 78(4) Apr

1986, US: National Medical Association; 1986, 327-329

Abstract/Review/Citation: Presents an overview of psychiatric disorders seen in

older patients and outlines a specific method of diagnosing the patient with

cognitive decline in a clear sensorium. It involves assessing drug

administration, emotional conditions, metabolic conditions, eyes and ears,

nutrition, tumors and trauma, infections, and artery disease. (20 ref)

========================================

 

Title: Successful treatment with captopril of an elderly man with polydipsia and

hyponatremia.

Author(s)/Editor(s): Tueth, Michael J.; Broderick-Cantwell, John

Source/Citation: Journal of Geriatric Psychiatry & Neurology; Vol 6(2)

Apr-Jun 1993, Canada: Decker Periodicals Inc; 1993, 112-114

Abstract/Review/Citation: Presents a case of a 64-yr-old alcoholic White male

with mild frontal lobe dementia resulting from brain trauma. The S had had at

least 5 episodes of polydipsia associated with hyponatremia, complicated by

seizures. The S was unsuccessfully treated with demeclocycline, then lithium

carbonate; effective treatment was administered in the form of 12.5 mg/day of

captopril. Within the 1st 15 days of hospitalization, the S's serum sodium

level dropped to the normal range.

========================================

 

Title: Early life trauma, infertility and late life paranoia: A relationship

with post traumatic stress disorder?

Author(s)/Editor(s): Busuttil, Walter; Aquilina, Charles; Busuttil, Angela

Source/Citation: International Journal of Geriatric Psychiatry; Vol 8(8) Aug

1993, US: John Wiley & Sons Inc; 1993, 693-695

Abstract/Review/Citation: Comments on B. S. Gurian's et al article on the possible relationship between late life paranoia and early trauma. This theory is discussed with reference to reports of stress-related disorders in concentration camp survivors from the

1940s-2960s. It is suggested that Gurian's et al Ss may have suffered from

posttraumatic stress disorder (PTSD). ========================================

 

Title: Sexual problems associated with dementia: I. Problems and their

consequences.

Author(s)/Editor(s): Haddad, Peter M.; Benbow, Susan M.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 8(7) Jul

1993, US: John Wiley & Sons Inc; 1993, 547-551

Abstract/Review/Citation: Examines possible reasons for the dearth of research

on sexual problems in elderly demented individuals, outlines the types of

sexual problems associated with dementia, and discusses their consequences.

Reasons for the neglect relate to the fact that noncognitive aspects of

dementia have generally received less attention than cognitive aspects, the

embarrassing nature of the topic, ethical issues, and stereotypes of the

elderly as sexless. Sexual problems consist of those involving an established

partner, those involving a new partner, those independent of a sexual partner

(e.g., sexual acting out, inappropriate sexual talk, and false sexual

allegations), and sexual abuse. Such problems can impair the quality of life

and impair affection and closeness, and may lead to confinement in the home

for the demented individual. Physical trauma may also result. ========================================

 

Title: The dexamethasone suppression test in psychiatric disorders.

Author(s)/Editor(s): Rothschild, Anthony J.

Source/Citation: Psychiatric Annals; Vol 23(12) Dec 1993, US: SLACK Inc; 1993,

662-670

Abstract/Review/Citation: Discusses uses of the dexamethasone suppression test

(DST) in clinical situations pertaining to such conditions as affective

disorders, major depression with psychotic features, geriatric depression, and

dysthymic disorder/borderline personality disorder. Also discussed is the use

of the DST in studying schizophrenia, panic disorder, obsessive-compulsive

disorder, posttraumatic stress disorder (PTSD), and eating disorders. It is

concluded that although the use of the DST in the clinical setting has

decreased, the test may have utility in certain situations, such as the

differentiation of major depression with psychotic features from

schizophrenia. However, it is noted that attempts to correlate abnormalities

observed on administration of the DST (with the exception of psychotic

depression) have met with limited success. ========================================

 

Title: Geriatric issues: Special considerations.

Author(s)/Editor(s): Murphy, Claire; Davidson, Terence M.

Source/Citation: Journal of Head Trauma Rehabilitation; Vol 7(1) Mar 1992, US:

Aspen Publishers Inc; 1992, 76-82

Abstract/Review/Citation: Discusses age-associated losses in the ability to

taste and smell and addresses the effects of trauma-related taste and smell

impairments in the elderly. In such cases, traumatic loss is superimposed on

an already existing loss. Olfactory loss actually contributes more than taste

loss to older people's difficulty with food appreciation. Odor-threshold

sensitivity decreases, odor intensity decreases, and the ability to identify

and remember odors is reduced. Designing appropriate rehabilitation for

geriatric trauma patients with olfaction or gustation impairments is

described.

========================================

 

Title: Late-life paranoia: Possible association with early trauma and

infertility.

Author(s)/Editor(s): Gurian, Bennett S.; Wexler, Debra; Baker, Errol H.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 7(4) Apr

1992, US: John Wiley & Sons Inc; 1992, 277-284

Abstract/Review/Citation: Studied data on 39 persons (aged 60-93 yrs) with

late-life onset of paranoid symptoms. A subset of 9 female Ss met the criteria

for delusional disorder (DD). DD Ss differed significantly from demented and

long-term schizophrenic Ss on a number of variables. Among the DD Ss, (1)

there was only 1 live birth, (2) more than half were refugees or holocaust

survivors, (3) there was an absence of a predicted sensory loss, and (4) the

manifestation of the paranoia was qualitatively different. Discussion

addresses the existence of a late-life delusional state that is neither

schizophrenia nor dementia and indicates that the paranoia in DD Ss cannot be

accounted for exclusively by a social isolation hypothesis. Also considered is

the interaction among early trauma, absence of children, and appearance of

paranoid ideation late in life.

========================================

 

Title: Risk factors for Alzheimer's Disease.

Author(s)/Editor(s): Amaducci, Luigi; Lippi, A.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 7(6) Jun

1992, US: John Wiley & Sons Inc; 1992, 383-388

Abstract/Review/Citation: Discusses some of the possible risk factors in the

development of Alzheimer's disease (AD): age, gender, Down's syndrome in the

S, and a history of dementia in 1st degree relatives. Evidence suggests the

possible role of late maternal age at S's birth and previous depression as

risk factors for AD. Among environmental factors, the role of head trauma is

supported by a number of studies. The relationship between education and brain

function is also discussed. Low education could reduce the margin of brain

reserve to a level at which a limited brain pathology can result in a dementia

syndrome (DS). Also, less educated people may be more exposed to environmental

factors that may lead to a DS.

========================================

 

Title: Alcohol abuse in elderly emergency department patients.

Author(s)/Editor(s): Adams, Wendy L.; Magruder-Habib, Kathryn; Trued, Sally; Broome, Harry L.

Source/Citation: Journal of the American Geriatrics Society; Vol 40(12) Dec

1992, US: Lippincott Williams & Wilkins; 1992, 1236-1240

Abstract/Review/Citation: Investigated the prevalence of alcohol abuse in 205

elderly emergency department (ED) patients (aged 65+ yrs) for various

categories of illness and injury and examined the frequency of detection of

elderly alcohol abusers by ED physicians. The prevalence of lifetime alcohol

abuse was 24%. The prevalence of current alcohol abuse was 14%. There was a

high prevalence among Ss presenting with abdominal problems and a low

prevalence among Ss who presented with falls or other trauma. Physicians

detected only 21% of the current alcohol abusers. Alcohol abuse is prevalent

but not well detected by physicians among elderly ED patients. Alcohol abuse

appears to be less common among elderly trauma patients than their younger

counterparts, but is very common among patients with abdominal problems.

========================================

 

Title: Alzheimer's disease: New insights into an emerging epidemic.

Author(s)/Editor(s): Selkoe, Dennis J.

Source/Citation: Journal of Geriatric Psychiatry; Vol 25(2) 1992, US:

International Universities Press Inc; 1992, 211-227

Abstract/Review/Citation: Emphasizes the clinical approach to the diagnosis and

management of Alzheimer's disease (AD), discusses the definition of dementia,

and reviews the major recent advances that have been made in understanding the

pathogenesis of this disorder. One of the most characteristic clinical

features of AD is its insidious onset and inexorable progression. A careful

history is the most important feature of the clinical evaluation of patients

with suspected AD. In addition to recording the 1st symptoms, examples of

typical errors or confusional episodes, and the approximate rate of

deterioration, the physician must inquire about possible transient ischemic

attacks and minor or major head trauma. Although AD is an emerging epidemic,

there is (at present) no proven effective pharmaceutical agent for its

treatment.

========================================

 

Title: Dementing illness in African American populations: Evaluation and

management for the primary physician.

Author(s)/Editor(s): Baker, F. M.

Source/Citation: Journal of Geriatric Psychiatry; Vol 24(1) 1991, US:

International Universities Press Inc; 1991, 73-91

Abstract/Review/Citation: Reviews the current literature on dementing illness in

older Blacks. Based on the medical problems of the Black community identified

in national studies, the potential for an increased prevalence of alcoholic

dementia, multi-infarct dementia, and acquired immune deficiency syndrome

(AIDS) dementia have been documented. The increased prevalence of head trauma,

particularly in Black males, may result in a high prevalence of clinically

diagnosed Alzheimer's disease. The difficulty of appropriately diagnosing

cognitive impairment in elderly Blacks is addressed. Case histories of a

62-yr-old man and a 78-yr-old woman illustrate the importance of history from

the social networks of elderly Blacks.

========================================

 

Title: Biopsychosocial trauma and the urban elderly.

Author(s)/Editor(s): Lightfoot, Orlando B.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 175-192

Abstract/Review/Citation: The urban environment is an appropriate setting to

view the dynamic interaction of biopsychosocial factors in the lives of a

diverse group of elderly individuals. The impact of potentially traumatic

events is important to recognize and understand. The psychiatrist has a

definite role as a member of a closely coordinated multidisciplinary team.

Family member of traumatized patents are a vibrant force in the life of an

identified patient, and they interact intimately with the patient and

caregivers. Case examples of both patients and caregivers are presented.

========================================

 

Title: Victims or survivors? A three-part approach to working with older adults

in disaster.

Author(s)/Editor(s): Massey, Barbara A.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 193-202

Abstract/Review/Citation: Outlines a 3-part approach for professional caregivers

working with older adults in a disaster: a description of the impact of losses

and trauma; assessment of the signs and symptoms of loss and trauma; and

interventions to help older survivors. These approaches will help professional

caregivers allay the fears and prevent posttraumatic stress which can shorten

the life of older adults in a disaster.

========================================

 

Title: Survivors: A review of the late-life effects of prior psychological

trauma.

Author(s)/Editor(s): Sadavoy, Joel

Source/Citation: American Journal of Geriatric Psychiatry; Vol 5(4) Fal 1997,

US: American Psychiatric Press Inc; 1997, 287-301

Abstract/Review/Citation: Reviews the literature on the epidemiology, symptom

picture, and treatment of elderly patients who have encountered serious

psychological trauma earlier in life. Data are predominantly derived from

studies of aging Holocaust survivors and combat veterans from World War II,

the Korean Conflict, and Vietnam. Results show that survivor syndromes persist

into old age, but patterns of expression vary. Holocaust survivors appear to

have adapted well to instrumental aspects of life, whereas combat warriors may

show less functional life-adaptation. Persisting symptoms in all groups

include marked disruptions of sleep and dreaming, intrusive memories,

impairment of trust, avoidance of stressors, and heightened vulnerability to

various types of age-associated retraumatization. There is a deficiency of

controlled treatment studies of traumatized elderly patients, but successful

group, individual, and family clinical interventions have been described.

========================================

 

Title: Subclinical stress responses in noncombatants.

Author(s)/Editor(s): Dobson, Matthew; Marshall, Richard P.; Grayson, David A.

Source/Citation: Journal of Nervous & Mental Disease; Vol 184(7) Jul 1996,

US: Lippincott Williams & Wilkins; 1996, 437-439

Abstract/Review/Citation: Highlights the significance of subclinical stress

responses among noncombatants in a war zone. The authors present case reports

of 2 male veterans, 43 and 62 yrs old, who experienced symptoms as a

consequence of their exposure to the war-zone experience rather than in the

wake of a specific traumatic event. The value of current prevention and

trauma-based treatment strategies for this group of the veteran population is

called into question.

========================================

 

Title: The stressor criterion and diagnosing posttraumatic stress disorder in a

legal context.

Author(s)/Editor(s): Dobson, Matthew; Marshall, Richard P.

Source/Citation: Australian Psychologist; Vol 31(3) Nov 1996, Australia:

Australian Psychological Society; 1996, 219-223

Abstract/Review/Citation: R. A. Bryant outlined a case where an applicant claimed to be suffering from posttraumatic stress disorder (PTSD) following exposure to atomic testing. In his paper, Bryant discusses the legal definition of a stressor, highlighting the ambiguity which remains in the Mental Disorders-IV (DSM-IV) definition of the stressor

criterion. This comment does not question Bryant's argument concerning the

ambiguity of the stressor criterion, but questions the view that there might

be some way of objectifying the definition of a stressor in the diagnosis of

PTSD, thereby standardizing the diagnosis. The authors' perspective on the

PTSD diagnosis is biased by their experience as clinicians and researchers in

the field of war-related trauma. Although PTSD has been conceptualized as an

anxiety reaction that follows in the wake of exposure to an extreme event,

there may not be a discrete class of stressors that cause PTSD. In supporting

this view, it is argued that the etiology of PTSD is multidimensional. It

follows that PTSD cannot be understood in terms of a cause-effect type

relationship between the stressor and symptoms, as is required for the

assessment of compensation/litigation claims in the courtroom setting.

========================================

 

Title: Memory and attention in the healthy elderly.

Author(s)/Editor(s): Orchard, Rebecca Jean

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 55(9-B) Mar 1995, US: Univ. Microfilms International;

1995, 4165

Abstract/Review/Citation: The 'normal aging process,' as traditionally

conceptualized, presumes cognitive decrements with age, independent of

pathology. However, this expectation is based upon results of studies whose

samples were inadequately screened for health status. Normative samples in

geriatric neuropsychology research, for example, were screened for obvious

factors such as history of head trauma and neurological disorders, but not for

chronic systemic illnesses such as diabetes and hypertension, which we now

realize adversely affect cognitive functioning. This study investigated the

influence of age and health status on verbal and visual memory and attention.

The objective was to select subjects resembling participants in normative

studies, and to contrast the genuinely healthy component with the

'contaminants.' A rigorous and detailed self-report of health status plus a

standard neurological examination were used to screen and divide subjects into

two health status groups: normal and super healthy. It was speculated that the

strong effect of age on memory and attention commonly found among the elderly

would be diminished with more restrictive control over health status.

Specifically, age was predicted to significantly affect performance in the

less healthy group alone. Also, the super healthy were predicted to outperform

the normals, regardless of age. Contrary to prediction, the super healthy did

not outperform the normals when scores were adjusted for three covariates:

vocabulary, education, and depression. (However, in exploratory analyses in

which covariates were dropped, the super healthy did outperform the normals on

verbal memory tests.) Likewise contrary to prediction, there was no evidence

of an age by health status interaction, with or without covariates. While

these negative results fail to challenge traditional findings, a lack of

findings regarding age in the current study is surprising, and may indicate

the value of rigorous screening in studies of this type.

========================================

 

Title: Listening with different ears:  Counseling people over sixty.

Author(s)/Editor(s): Warnick, James

Source/Citation: Fort Bragg, CA, US: QED Press; 1995, (vi, 215)

Abstract/Review/Citation: Warnick demonstrates effective and creative techniques

the counselor can use [when working with elderly persons]. He indicates what

works and what doesn't and provides a refreshing and original slant on the

subject. He shows in a practical, optimistic way that working with

"third-age" people . . . can be extremely rewarding.  [This book] challenges

outdated beliefs about aging and explains how to help older people cope with

transitions, trauma and stress; offers approaches and solutions to

12 major problems that confront older people; contains . . . case histories

and suggestions for treatment; melds several therapeutic approaches to create

a warm, caring counseling relationship while offering a concrete,

goal-oriented approach to problem solving.  [This book is for] anyone who

works with seniors in a helping capacity, including counselors, therapists,

senior center outreach workers, family physicians, psychologists, clergy,

long-term care professionals, educators and health workers. . . . It is also

[a] supplemental text for social service, gerontological and social psychology

courses.

Notes/Comments:  Preface Section one: Introducing the third age Why

counsel the third age? Pressures of the third age Counseling mechanics

Considerations when dealing with third age people Section two: Major problems

Anxiety, depression, and abnormal grief Retirement and independent living

Health problems and pain management Marital, relationship, and personality

problems Lifestyle dissatisfaction, lifelong problems, and substance abuse

Dementia and late onset paranoia Suicide, terminal illness, and traumatic

experiences Ten case studies Section three: Solutions Making it work

Appendices Assessment aid The initial session Brief therapy Cognitive therapy

aids Helping clients understand themselves Supportive therapy aids Relaxation

aids Psychiatric medication review Resources Index techniques for counseling

& coping with transitions & trauma & stress, elderly

========================================

 

Title: Childhood abuse history in older women with panic disorder.

Author(s)/Editor(s): Sheikh, Javaid I.; Swales, Pamela J.; Kravitz, Jean;

Bail, Gregory; et al

Source/Citation: American Journal of Geriatric Psychiatry; Vol 2(1) Win 1994,

US: American Psychiatric Press Inc; 1994, 75-77

Abstract/Review/Citation: 17 women (aged 55-73 yrs) participating in a clinical

trial for older panic disorder patients were administered the Childhood Trauma

Questionnaire by M. Folstein et al (see record 1976-20785-001). Seven Ss

reported histories of sexual abuse. Physical abuse was reported by lO Ss,

including 6 of the 7 who also reported sexual abuse. The data raise questions

regarding the possible contributory role of childhood trauma in some panic

disorder patients.

========================================

 

Title: Handbook of play therapy, Vol. 2:  Advances and innovations.

Author(s)/Editor(s): O'Connor, Kevin J.; Schaefer, Charles E.

Source/Citation: New York, NY: John Wiley & Sons; 1994, (xiv, 447) Wiley

series on personality processes.

Abstract/Review/Citation: "The Handbook of Play Therapy, Volume Two:

Advances and Innovations" considerably expands on the first volume

[published in 1983] by presenting the theoretical, technical, and

methodological advances coming out of this steadily growing field.  Leading

authorities on the various aspects of play therapy [were invited] to write

original chapters presenting the developments that have occurred in the field

since 1983. Material [included] is interdisciplinary in approach, eclectic in

theory, and comprehensive in scope.  Psychiatrists, psychologists, social

workers, nurses, and counselors at all levels of training and experience will

find this [handbook] informative, thought provoking, and clinically useful.

Notes/Comments: Print (Paper) Human 10 Childhood (birth-12 yrs) 100 Part 1:

Theoretical approaches to the practice of play therapy Adlerian play therapy 

Terry Kottman Time-limited play therapy  Richard E. Sloves and Karen Belinger

Peterlin Ecosystemic play therapy  Kevin J. O'Connor Dynamic play therapy:

Expressive play intervention with families  Steven Harvey Cognitive-behavioral

play therapy  Susan M. Knell Gestalt play therapy  Violet Oaklander Part 2:

Developmental adaptations of play therapy Adolescent theraplay  Terrence J.

Koller The use of play therapy with adults  Diane E. Frey Geriatric theraplay 

Sandra Lindaman and Debra Haldeman Part 3: Play therapy techniques and methods

The Erica Method of sand play diagnosis and assessment  Margareta Sjolund and

Charles E. Schaefer Jungian play therapy techniques  Gisela De Domenico The

Good Feeling-Bad Feeling Game  Sue Ammen Part 4: Play therapy applications

Play therapy for psychic trauma in children  Charles E. Schaefer Play

diagnosis and play therapy with child victims of incest  Jamshid A. Marvasti

Play therapy with mentally retarded clients  Joop Hellendoorn Filial therapy

for adoptive children and parents  Rise Van Fleet Play therapy with children

of alcoholics and addicts  Mary Hammond-Newman A structured activities group

for sexually abused children  Scott J. Van de Putte Author index Subject index

theoretical approaches to & techniques & methods & applications of

play therapy, children, handbook Handbook/Manual/Guide 6000

========================================

 

Title: The interdisciplinary approach to treating the traumatized personality

disordered elderly patient.

Author(s)/Editor(s): Johnson, Susan T.

Source/Citation: Journal of Geriatric Psychiatry; Vol 27(2) 1994, US:

International Universities Press Inc; 1994, 221-240

Abstract/Review/Citation: Contends that assessing the treatment needs of elderly

individuals in community or institutional settings involves taking into

account their psychiatric diagnoses, psychosocial and emotional problems, and

physical illnesses. Two clinical cases of individuals with personality

disorders stemming from childhood trauma illustrate the work of

interdisciplinary team (IT) management in the community and in a residential

setting. Coordination of care was more difficult in the case of the female S

(in her late 70s) treated at home than in the case of the male S (in his

mid-80s) treated in a rest home where the IT was already in place. ========================================

 

Title: Early loss of mother or father predicts depression in old age.

Author(s)/Editor(s): Kivelae, Sirkka-Liisa; Luukinen, Heikki; Koski, Keijo; Viramo, Petteri; Pahkala, Kimmo

Source/Citation: International Journal of Geriatric Psychiatry; Vol 13(8) Aug

1998, US: John Wiley & Sons Inc; 1998, 527-530

Abstract/Review/Citation: The independent predictive roles of early losses,

personality traits, acute losses, and long-term stress situations for the

occurrence of depression in elderly Finns were described using a longitudinal

design. The persons non-depressed in an epidemiological study in 1984-1985

were interviewed in 1989-1990 (N = 679) and the occurrence of depression was

determined according to DSM-III criteria. Logistic regression models were used

to assess the independent roles of the hypothesized factors as predictors. An

early loss of the mother among men and an early loss of the father among women

independently predicted the occurrence of depression in logistic regression

models. Older age in men, and a higher number of symptoms, the occurrence of

previous depression, and not living alone in women were also independent

predictors. In men, impaired functional abilities and poor self-perceived

health tended to predict depression. In conclusion, the psychological trauma

that develops upon the experience of an early parental loss contributes to the

development of depression even in old age. The role of stressors in life as

independent predictors of depression in old age was also ascertained.

========================================

 

Title: Aging and cognition.

Author(s)/Editor(s): Keefover, Robert W.

Source/Citation: Neurologic Clinics; Vol 16(3) Aug 1998, US: W.B. Saunders &

Co.; 1998, 635-648

Abstract/Review/Citation: Reviews the age-related cognitive deficits of the

elderly. While these changes are often attributable to serious dementing

illnesses such as Alzheimer's disease (AD), a surprising number result from

apparently normal aging processes. The effects of senescence on cognition may

be indirect (i.e., gait instability leading to falling and subsequent head

trauma); however, they may have a more direct and subtle impact on the brain.

The evidence available to date suggests that only a limited range of cognitive

domains are susceptible to these aging effects. It is suggested that perhaps

the most important are short-term memory functions. As increasing numbers of

elderly patients seek neurologic consultation for deteriorating intellectual

capacities, physicians must be cognizant of the full spectrum of

aging-associated cognitive disorders. ========================================

 

Title: Soul of the singing swan: A psychospiritual-Jungian approach to healing

the ruptured mother-child archetype.

Author(s)/Editor(s): Sklover-Filgate, Leesa B.

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 58(12-B) Jun 1998, US: Univ Microfilms International;

1998, 6827

Abstract/Review/Citation: This study enters the phenomenological experience of a

woman of thirty-eight who suffered an amniotic fluid embolism during

childbirth, eight years prior. It resulted in a stroke with brain stem,

frontal lobe, bilateral damage. Quadraplegia and dysphagia (difficulty

swallowing) were cause for placement in a geriatric facility of a major

medical hospital. Rehabilitation for five years proved unsuccessful. After

years of traditional treatment geared towards stabilization, the study

introduced a psychospiritual psychotherapy, longterm, frequent process with

clinical behavioral therapies both of a verbal and non-verbal nature. An

analytic/existential theory base, helped make meaning out of existence, after

the rupturing of the mother/child archetype. Pessimism, inherent in treating

the neurologically impaired with psychotherapy, was confronted with a process

called 'neuropsychotherapy' that suggests true healing occurs through

interpersonal relationship rather than protocol. The case study focused on the

archetypal dynamic between therapist and patient. The process examined,

inspired the making of meaning out of trauma, as well as lessened depression,

evidenced through Becks, Hamilton and verbal assessment. ========================================

 

Title: Head injury and the risk of Alzheimer's disease: A case-control study.

Author(s)/Editor(s): Salib, Emad; Hillier, Valerie

Source/Citation: International Journal of Geriatric Psychiatry; Vol 12(3) Mar

1997, US: John Wiley & Sons Inc; 1997, 363-368

Abstract/Review/Citation: Examined 198 Alzheimer's disease (AD) Ss (mean age 77

yrs), 164 Ss with other dementias (mean age 75 yrs), and 176 Ss with no

dementia (mean age 73 yrs) to assess the reported association between head

injury and risk for AD and other dementias. Ss participated in a structured

interview to assess their history of head injury. Results confirm a positive

association between reported head injury and AD as well as non-Alzheimer type

dementia. Head trauma did not appear to be a specific risk for AD as

previously claimed. In addition, the association was significantly modified by

sex. There was no evidence found supporting an association with other risk

factors.

========================================

 

Title: Media triggers of post-traumatic stress disorder 50 years after the

Second World War.

Author(s)/Editor(s): Hilton, Claire

Source/Citation: International Journal of Geriatric Psychiatry; Vol 12(8) Aug

1997, US: John Wiley & Sons Inc; 1997, 862-867

Abstract/Review/Citation: Posttraumatic stress disorder (PTSD) may present many

years after the original trauma. The case studies of 2 elderly male patients

(aged 72 and 76 yrs) are presented to illustrate this later appearance of

PTSD. Both patients had experienced life-threatening combat situations and

witnessed intense suffering during WWII. Marked distress was triggered by the

media commemorating the 50th anniversary of the end of the war. PTSD patients

often avoid talking of their traumatic experiences because of associated

distress. Without taking a military and trauma history from elderly patients

the diagnosis is likely to be missed.

========================================

 

Title: American Psychiatric Press review of psychiatry, Vol. 16.

Author(s)/Editor(s): Dickstein, Leah J.; Riba, Michelle B.; Oldham, John M.

Source/Citation: Washington, DC, US: American Psychiatric Press, Inc; 1997,

(lxvii, 824) American Psychiatric Press review of psychiatry, Vol. 16.

Abstract/Review/Citation: In the 16th volume of this psychiatric reference

series, more than 40 internationally and nationally recognized experts

describe and evaluate the latest research, treatment, and diagnostic advances

in the areas of cognitive therapy, repressed memories, obsessive-compulsive

disorder, psychopharmacology across the life span, and psychological and

biological testing issues for psychiatrists.  This volume also includes a

section devoted to the use of computers in clinical work that challenges

readers to consider how computers can be incorporated into patient care as we

approach the 21st century.

Notes/Comments: Contributors Foreword to American Psychiatric Press Review of Psychiatry, Volume 16 [by] Leah J. Dickstein, Michelle B. Riba and John M. Oldham Section I: Cognitive therapy Cognitive therapy for anxiety disorders David M. Clark and Adrian Wells Cognitive-behavioral therapy for substance abuse disorders Michael E. Thase Cognitive approaches to personality disorders Judith S. Beck

Cognitive-behavioral treatment of eating disorders James E. Mitchell and Carol

B. Peterson Cognitive therapy for chronic and severe mental disorders Jan

Scott and Jesse H. Wright Section II: Repressed memories Trauma and memory

Lisa D. Butler and David Spiegel Memory, repression, and abuse: Recovered

memory and confident reporting of the personal past Kevin M. McConkey

Intentional forgetting and voluntary thought suppression: Two potential

methods for coping with childhood trauma Wilma Koutstaal and Daniel L.

Schacter Perspectives on adult memories of childhood sexual abuse: A research

review Linda M. Williams and Victoria L. Banyard Repressed memories in

patients with dissociative disorder: Literature review, controlled study, and

treatment recommendations Philip M. Coons, Elizabeth S. Bowman and Victor

Milstein Section III: Obsessive-compulsive disorder across the life cycle

Obsessive-compulsive disorder in children and adolescents Joseph V. Penn, John

March and Henrietta L. Leonard Obsessive-compulsive disorder in adults Michele

T. Pato and Carlos N. Pato Obsessive-compulsive disorder in later life C. Alec

Pollard, Cheryl N. Carmin and Raymond Ownby Course of illness in

obsessive-compulsive disorder Jane Eisen and Gail Steketee

Obsessive-compulsive disorder in pregnancy and the puerperium Susan F. Diaz,

Lynn R. Grush, Deborah A. Sichel and Lee S. Cohen Section IV:

Psychopharmacology across the life span Psychopharmacological treatment of

psychotic disorders across the life span Paul E. Keck, Jr. and Stephen M.

Strakowski Psychopharmacological treatment of bipolar disorder across the life

span Susan L. McElroy and Elizabeth Weller Pharmacotherapy of

attention-deficit/hyperactivity disorder: A life span perspective Thomas

Spencer, Joseph Biederman and Timothy Wilens Child and adolescent

psychopharmacology Scott A. West Overview of geriatric psychopharmacology

Andrew Satlin and Charles Wasserman Section V: Psychological and biological

assessment at the turn of the century The laboratory in clinical psychiatry

Philip G. Janicak and Elizabeth A. Winans Psychological assessment in a

managed care climate: The neuropsychological evaluation Steven Mattis and

Barbara C. Wilson Guidelines for selecting psychological instruments for

treatment outcome assessment Frederick L. Newman and Daniel Carpenter

Performance measurement in healthcare delivery systems Naakesh A. Dewan and

Daniel Carpenter Section VI: Computers, the patient, and the psychiatrist

Computers and patient care Zebulon Taintor, Marc Schwartz and Marvin Miller

Using the internet Bertram Warren, Thomas Kramer, Steven E. Hyler and Robert

Kennedy 2005: Information technology impacts psychiatry Norman Alessi, Milton

Huang and Paul Quinlan Afterword to American Psychiatric Press Review of

Psychiatry, Volume 16 [by] Leah J. Dickstein, Michelle B. Riba and John M.

Oldham Index research & treatment & diagnostic advances in cognitive

therapy & repressed memories & obsessive-compulsive disorder &

psychopharmacology & testing issues for psychiatrists & clinical use of computers

========================================

 

Title: Neurobiological perspectives on trauma and aging.

Author(s)/Editor(s): Bergherr, Theresa; Bremner, J. Douglas; Southwick, Steven M.; Charney, Dennis S.; Krystal, John H.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 27-59

Abstract/Review/Citation: Notes that neurobiological perspectives may help to

integrate a diversity of clinical findings regarding aging trauma survivors,

to inform considerations about the course of posttraumatic stress disorder

(PTSD), and to suggest new avenues for treatment. This article begins with a

review of epidemiological and clinical data regarding the long-term course of

PTSD. The authors then focus on 2 aspects of the emerging neurobiology of PTSD

that appear to be relevant to the course of this disorder: alterations in the

regulation of the hypothalamo-pituitary-adrenal-axis and in noradrenergic

systems. In doing so, they consider advances from neuroendocrinology,

psychopharmacology, and brain imaging studies. Prognostic and treatment issues

raised in the process of integrating neurobiological and clinical findings are

considered.

========================================

 

Title: Late life effects of trauma: Adult catastrophic and infantile type.

Author(s)/Editor(s): Krystal, Henry

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 61-82

Abstract/Review/Citation: Presents the author's conceptualizaiton of adult

catastrophic trauma vs infantile trauma, as well as data from a 50-yr followup

of the emotional trauma of 62 Holocaust survivors. The author posits that the

adult traumatic process starts with basically the same point that Freud made

in 1926: "the essence and meaning" of the traumatic situation is

"the subject's estimation of his own strength <--p<--p . and his

admission of helplessness in the face of it." Confrontation with

avoidable or manageable danger evokes fear. The discovery that one is helpless

in the face of an unavoidable danger is reacted to with a paralyzing affect

which M. Stern (1951, 1968) called "catatanoid reaction." This

affect initiates the traumatic process. In contrast, the infantile (but not

childhood) traumatic state is initiated by the infantile affect precursors. 

If empathic mothering is not restored quickly, failure to thrive, hospitalism,

or maramus will set in. If the infant does not die of it, he or she will, with

any significant duration of the early disaster, have some of the same sequels

as adults. From the followup of Holocaust survivors, the patients were able to

describe their sleeping disturbances, multiple pains derived from a number of

sources, and a variety of psychosomatic diseases. ========================================

 

Title: "Late life effects of trauma": Discussion.

Author(s)/Editor(s): Herzog, James M.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 83-90

Abstract/Review/Citation: Comments on H. Krystal's (1997) conceptualization of

the differences between infantile and adult-onset catastrophic trauma. Herzog

blurs somewhat this distinction in terms of ongoing mechanisms by which the

individual manages and requires comanagement of overwhelming exigencies and

circumstances of internal and external danger. The questions of affect

tolerance, play capacity, and the nature of accompaniment and protection are

central to this discussion. The model that Herzog proposes in response to

Krystal acknowledges that intrapsychic as well as interactive catastrophe has

occurred and that attempts at restitution and repair are continuous. ========================================

 

Title: A life-span perspective on the effects of military service.

Author(s)/Editor(s): Spiro, Avron III; Schnurr, Paula P.; Aldwin, Carolyn M.

Source/Citation: Journal of Geriatric Psychiatry; Vol 30(1) 1997, US:

International Universities Press Inc; 1997, 91-128

Abstract/Review/Citation: Proposes the adoption of a life-span perspective on

the effects of military service on socioeconomic, psychological, and health

outcomes. Using data from community-residing men participating in the

longitudinal Normative Aging Study (NAS), most of whom happened to be

veterans, the authors examined 3 developmental issues. These issues relate to

the hypothesis that military service has effects on health that might be

mistaken for the effects of aging. Of the 1,802 men from the original NAS

panel who were still living in 1995, 86% were still participating. The 1st

question was whether measures developed to assess posttraumatic stress

disorder (PTSD) in younger Vietnam veterans are useful for older veterans.

Should the same cut-off scores be used on these questionnaires, regardless of

age, to make the putative diagnosis of PTSD? If one assumes that these

measures are valid for older veterans, the present results demonstrate the

existence of PTSD among older veterans, and that its current prevalence is

related to combat exposure. The remaining issues relate to changes in distress

(i.e., PTSD) over time in response to trauma (i.e., combat exposure), and the

long-term effects of military service on health outcomes, considering mental

and physical health and health care utilization. ========================================

 

Title: Neurobehavioral effects following geriatric head injury.

Author(s)/Editor(s): Cisewski, Dawn Marie

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 62(9-B) Apr 2002, US: Univ Microfilms International;

2002, 4213

Abstract/Review/Citation: This study compared the acute neuropsychological

effects of a mild head injury in a geriatric population and a young adult

population. Forty-one young adult individuals (mean age = 23.6 years, s.d. =

3.1) and 29 geriatric individuals (mean age = 67.1 years, s.d. = 4.4) were

evaluated using a standard neuropsychological trauma battery at Allegheny

General Hospital following admission to the trauma unit. This study also

examined the reliability and utility of specific neuropsychological measures

in differentiating between individuals who were diagnosed with a head injury

and those who were not. In addition to the aforementioned groups, the

neuropsychological battery was administered to 10 non-head injured young adult

trauma patients (mean age = 25.1, s.d. = 3.84) and 15 non-head injured

geriatric trauma patients (mean age = 68.7, s.d. = 6.84). Results of the study

indicated significant differences on memory, attention/concentration, and

executive functioning for age. However, no significant differences were found

on these measures for head injured vs. non-head injured, and no interaction

between age and head injury was found. These findings were further supported

by the results of the analyses using age appropriate norms, in which no

significant differences were found for these groups on measures of memory and

attention/concentration. The findings of this study suggest that premorbidly

healthy geriatric populations suffer similar neuropsychological effects

following a mild head injury as a young adult population. This study also

raises the possibility that the assessment and diagnostic procedures of

individuals who are admitted to a hospital following a fall or motor vehicle

accident may need to be refined. The lack of significant differences between

head injured and non-head injured individuals raises the possibility that

factors such as diagnostic criteria, referral procedures, and psychological or

physical distress affected neuropsychological test performance. ========================================

 

Title: Contribution of PTSD/POW history to behavioral disturbances in dementia. 

Author(s)/Editor(s): Verma, Swapna; Orengo, Claudia A.; Maxwell, Rebecca; Kunik, Mark E.; Molinari, Victor A.; Vasterling, Jennifer J.; Hale, D. Danielle

Source/Citation: International Journal of Geriatric Psychiatry: Special Issue: 

Vol 16(4) Apr 2001, US: John Wiley & Sons Inc; 2001, 356-360

Abstract/Review/Citation: As many WW II and Korean Conflict veterans suffering

from posttraumatic stress disorder (PTSD) grow older, increasing numbers will

be diagnosed with dementia. The authors retrospectively analyzed patients with

dementia, comparing the behavioral disturbances of those with vs without PTSD.

It was hypothesized that due to the additive effect of the neurobiological and

behavioral changes associated with PTSD and dementia, the dementia with PTSD

group would show more agitation and disinhibition than the dementia without

PTSD group. 16 Ss with diagnoses of dementia and PTSD were matched on age and

Mini-Mental States Examination scores to 16 Ss with dementia without PTSD. Ss

with diagnoses of dementia with PTSD did not differ significantly in their

clinical presentation, hospital course, and condition at discharge from Ss

with dementia without PTSD. Significantly more PTSD Ss were prescribed

anti-depressants compared to the non-PTSD group. Within the PTSD group, the

subgroup of Ss who were former POWs had a higher mean score for paranoia and

less verbal agitation. This study reveals that a diagnosis of PTSD alone is

not sufficient to influence behavior in veterans with dementia; however, the

authors also present provocative results that patients with more severe trauma

(POW) do have changes in their behavior.

========================================

 

Title: Clinical perspectives on elderly sexuality.

Author(s)/Editor(s): Hillman, Jennifer L.

Source/Citation: New York, NY, US: Kluwer Academic/Plenum Publishers; 2000, (ix,

206) Issues in the practice of psychology.

Abstract/Review/Citation: With the growth of the older adult population and the

increasing need for health care providers with geriatric training, the author

suggests that students and practitioners must become familiar with the

multifaceted issues of sexuality.  This book features a combination of

research findings, clinical case studies, and specific guidelines for

assessment and intervention. A variety of topics typically neglected in this

population, such as body image and eating disorders, HIV, the long term impact

of sexual trauma in late life, sexuality in institutional settings, sexuality

for partners of older adults with dementia and other chronic illnesses,

traditional and nontraditional relationships, and information about

medications that can cause sexual dysfunction, are reviewed in detailed.

In addition, practitioners are given practical suggestions for interviewing

older adults about sexual issues, working with character-disordered older

adults, managing sexualized transference in the therapeutic relationship,

mediating conflict between professionals on interdisciplinary teams, and

assessing HIV and HIV-induced dementia.  The suggested audience for this

book is clinicians and students of psychology, social work, gerontology,

sociology, and physical therapy.

========================================

 

Title: A review of the phenomenology and cognitive neuropsychological origins of

the Capgras syndrome.

Author(s)/Editor(s): Edelstyn, N. M. J.; Oyebode, F.

Source/Citation: International Journal of Geriatric Psychiatry; Vol 14(1) Jan

1999, US: John Wiley & Sons Inc; 1999, 48-59

Abstract/Review/Citation: Reviews the literature on the epidemiology, etiology,

neuroanatomy and neuropsychology of Capgras syndrome (CS). CS is characterized

by the delusional belief that one or a few highly familiar people have been

replaced by impostors who are physically very similar to the original(s). The

patient acknowledges that the double and known person look alike, but

maintains the belief that the significant person, in psychological terms, is

absent. CS is relatively rare, occurring predominantly in the context of

schizophrenia, and was traditionally considered to have its origins in

psychodynamic conflict. More recently, it has been estimated that between 21

and 40% of cases are associated with organic disorders, which include

dementia, head trauma, epilepsy and cerebrovascular disease. Neuroimaging

evidence suggests a link between CS and right hemisphere abnormalities,

particularly in the frontal and temporal regions. Neuropsychological research

has provided empirical support for these findings, by consistently reporting

the presence of impairments in facial processing-an established right

hemisphere function.

========================================

 

Title: Handbook of counseling and psychotherapy with older adults.

Author(s)/Editor(s): Duffy, Michael

Source/Citation: New York, NY, US: John Wiley & Sons, Inc; 1999, (xx, 721)

Abstract/Review/Citation: This handbook provides a much needed resource in

treatment approaches for mental health professionals who provide counseling

and psychotherapy to older clients. Part I focuses on a series of treatment

modalities, including the use of psychotherapy process, group and expressive

approaches, family and intergenerational interventions, and social and

community interventions. Part II provides conceptual and best practice

interventions for a series of specific problems. This volume will be useful to

a variety of interested persons, including experienced geropsychologists and

geropsychiatrists, geropsychiatric nurses and social workers, and counselors

who focus on mental health and aging. It will also be an important resource

for experienced general therapists who wish to develop greater proficiency in

working with older adults. (PsycINFO Database Record (c) 2000 APA, all rights

reserved)

Notes/Comments: Print (Paper) Human 10 Adulthood (18 yrs & older) 300 Aged

(65 yrs & older) 380 Very Old (85 yrs & older) 390 Preface

Acknowledgments Part One: Approaches to psychotherapy with older adults Issues

in psychotherapy process with older adults Using process dimensions in

psychotherapy: The case of the older adult Michael Duffy Transferential and

countertransferential processes in therapy with older adults Nancy A. Newton

and Jordan Jacobowitz Adjusting to role loss and leisure in later life Jane E.

Myers Addressing late life developmental issues for women: Body image,

sexuality, and intimacy Royda G. Crose Developmental issues in psychotherapy

with older men Margaret Hellie Huyck and David L. Gutmann Existential issues

of hope and meaning in late life therapy Claire M. Brody It takes two:

Therapeutic alliance with older clients Helen Q. Kivnick and Audrey Kavka The

impact of cultural differences in psychotherapy with older clients: Sensitive

issues and strategies Pamilla Morales Group and expressive therapy approaches

Using reminiscence and life review as natural therapeutic strategies in group

therapy Victor Molinari Integrated group approaches with the early stage

Alzheimer's patient and family Robert E. Reichlin The role of art therapy in

aiding older adults with life transitions Jules C. Weiss Using music therapy

in treating psychological problems of older adults Suzanne B. Hanser

Therapeutic issues and strategies in group therapy with older men David G.

Sprenkel Family and intergenerational interventions Realizing power in

intergenerational family hierarchies: Family reorganization when older adults

decline Sara Honn Qualls Couple therapy with long-married older adults Erlene

Rosowsky Dynamics and treatment of middle-generation women: Heroines and

victims of multigenerational families Donna S. Davenport Family disruption:

Understanding and treating the effects of dementia onset and nursing home

placement Deborah W. Frazer Sexual dysfunction: Using an interdisciplinary

team to combine cognitive-behavioral and medical approaches Antonette M. Zeiss

and Robert A. Zeiss Social and community interventions Preventive

interventions for older adults Candace Konnert, Margaret Gatz and E. A. Meyen

Hertzsprung Enhancing mental health climate in hospitals and nursing homes:

Collaboration strategies for medical and mental health staff Karen Sanders, Jo

Ann Brockway, Beatrice Ellis, Elizabeth M. Cotton and June Bredin

Environmental design features and the well-being of older persons M. Powell

Lawton Critical issues and strategies in mental health consultation in nursing

homes Michael A. Smyer and Maureen Wilson Prevention and promotion models of

intervention for strengthening aging families Gregory C. Smith Part Two:

Treatment approaches for selected problems Personality disorders The effect of

personality disorder on Axis I disorders in the elderly Joel Sadavoy Treating

hypochondria in later life: Personality and health factors Damond

Logsdon-Conradsen and Lee Hyer A biopsychosocial approach to treatment of

schizophrenia in late life Stephen J. Bartels, Kristin J. Levine and Kim T.

Mueser Dynamics and treatment of narcissism in later life Jordan Jacobowitz

and Nancy A. Newton Anxiety and mood disorders Interpersonal psychotherapy for

late-life depression Gregory A. Hinrichsen Cognitive-behavioral therapy for

the treatment of late-life distress David W. Coon, Kenneth Rider, Dolores

Gallagher-Thompson and Larry Thompson Strategies for treating generalized

anxiety in the elderly Melinda A. Stanley and Patricia M. Averill Treating

obsessive-compulsive disorder in older adults: A review of strategies John E.

Calamari and Karen Lynn Cassiday The effects of trauma: Dynamics and treatment

of PTSD in the elderly Lee Hyer A guide to current psychopharmacological

treatments for affective disorders in older adults: Anxiety, agitation, and

depression Iris R. Bell Adjunctive psychological treatments for organic

disorders Reaching the person behind the dementia: Treating comorbid affective

disorders through subvocal and nonverbal strategies Michael Duffy Current

concepts and techniques in validation therapy Naomi Feil Memory training for

older adult medical patients in a primary health care setting Martha Li Chiu

Behavior disorders Management of alcohol abuse in older adults Larry W. Dupree

and Lawrence Schonfeld Psychotherapy with the suicidal elderly: A

family-oriented approach Joseph Richman Ethics of treatment in geropsychology:

Status and challenges J. Ray Hays Author index Subject index therapeutic

approaches in counseling & psychotherapy for older adults

========================================

 

Title: The effects of trauma: Dynamics and treatment of PTSD in the elderly.

Author(s)/Editor(s): Hyer, Lee

Source/Citation: Handbook of counseling and psychotherapy with older adults.,

New York, NY, US: John Wiley & Sons, Inc; 1999, (xx, 721), 539-560

Source editor(s): Duffy, Michael (Ed)

Abstract/Review/Citation: The study of stress and trauma in older people,

especially PTSD, is fraught with problems related to developmental issues and

life-span patterns. In this chapter, the authors consider stress as it applies

to older people, present research data on the general curative factor of

trauma, and address issues of the care of older victims. A treatment model for

older trauma victims is presented, along with a case illustration outlining

the features of the model.

========================================

 

Title: An assessment of Nazi concentration camp survivors for posttraumatic

stress disorder and neuropsychological concomitants.

Author(s)/Editor(s): Brody, Julie M.

Source/Citation: Dissertation Abstracts International: Section B: The Sciences

& Engineering; Vol 60(2-B) Aug 1999, US: Univ. Microfilms International;

1999, 0820

Abstract/Review/Citation: This study compared World War II survivors of Nazi

concentration camps, survivors who spent the majority of the war in ghettos,

hiding, labor camps, etc., and immigrant comparisons who fled Europe before

the war, on measures of affective and cognitive functioning. The total sample

consisted of 18 females (45%) and 22 males (55%), and the groups were not

balanced for gender. Brief historical interviews were conducted to gather

information about wartime/immigration conditions including illnesses,

beatings, head injury, and excessive weight loss. The Geriatric Depression

Scale and Structured Clinical Interview for DSM-IV-Past and Current Major

Depressive Episodes were administered to measure lifetime/current prevalence

of depression. The PTSD Checklist (PCL-S) was utilized to assess for current

PTSD symptom severity and presence of the disorder. The neuropsychological

measures employed were the Animal Naming Test, California Verbal Learning

Test, Digit Vigilance Test, Logical Memory and Visual Reproduction subtests of

the Wechsler Memory Scale-Revised, Raven's Coloured Progressive Matrices,

Trail Making Test-Parts A and B, and WAIS-R Vocabulary subtest. Premorbid Full

Scale IQ scores were estimated using a regression equation involving

Vocabulary scores and demographic variables. Concentration camp survivors

reported a significantly higher incidence of typhus, beatings, and head

injuries during wartime/immigration periods. They reported higher severity of

current PTSD symptoms overall than non-concentration camp survivors and

immigrant comparisons, but did not qualify for formal PTSD diagnoses more

often than the other groups. On the PTSD Checklist, avoidance symptoms were

endorsed more frequently by concentration camp survivors than the other

groups; however, the symptoms most commonly reported by both Holocaust

survivor groups were intrusive thoughts and memories of the war and distress

prompted by reminders of the trauma. Concentration camp survivors displayed

significantly poorer verbal memory skills than the non-concentration camp

survivors and immigrant comparisons on immediate and delayed recall trials of

the Wechsler Memory Scale-Revised paragraph-length stories, and intruded

significantly more novel words on recall trials of the California Verbal

Learning Test shopping list. The three groups performed statistically

similarly on the remaining neuropsychological measures. More than 50 years

after wartime internment, survivors of Nazi concentration camps continue to

demonstrate post traumatic symptomatology as well as neuropsychological

concomitants, specifically in the domain of verbal memory. ========================================

 

Title: Using atypical neuroleptic drugs to treat agitation in patients with a

brain injury: A review.

Author(s)/Editor(s): Burnett, Derek M.; Kennedy, Richard E.; Cifu, David X.; Levenson, James

Source/Citation: NeuroRehabilitation; Vol 13(3) 1999, Netherlands: IOS Press;

1999, 165-172

Abstract/Review/Citation: Agitation during brain injury rehabilitation remains a

significant impediment to expedient and effective care. While health care

providers differ in their definition of agitation, it is agreed that treatment

is usually best achieved using an interdisciplinary approach that includes

psychiatry and rehabilitation professionals. Neuroleptic drugs have been used

to effectively treat agitation but have a side effect profile that may have

long-term consequences on cognition and motor recovery. This literature review

presents the typical and atypical neuroleptics used to treat agitation,

research in support of their use, guidelines for drug selection, and special

considerations for trauma-related agitation in the elderly brain injured

population.

========================================

 

Title: Phenomenology and treatment of trauma in later life.

Author(s)/Editor(s): Hyer, Lee; Woods, M. G.

Source/Citation: Cognitive-behavioral therapies for trauma., New York, NY, US:

The Guilford Press; 1998, (xii, 431), 383-414

Source editor(s): Follette, Victoria M. (Ed) Description/Edition Info.: Chapter; 160

Abstract/Review/Citation: Given that thinking in terms of posttraumatic stress

disorder (PTSD) will yield an imperfect picture of how trauma is adjusted to

in later life, the authors of this chapter address 3 issues. First, they

consider age and its role in the trauma experience. They primarily address

combat trauma, as many of the current older cohort of trauma sufferers

experienced trauma in World War II and the Korean War. Second, they look at

treatment studies and psychotherapy as these apply to older people and trauma

victims. Third, a cognitive-behavioral model of treatment is provided.

Finally, the authors consider both the caregiver and assessment. A brief case

example is presented.

========================================

 

Title: Rehabilitation.

Author(s)/Editor(s): Goldstein, Gerald; Beers, Sue R.

Source/Citation: New York, NY, US: Plenum Press; 1998, (xvi, 292) Human brain

function:  Assessment and rehabilitation.

Abstract/Review/Citation: This volume is the 4th in a series that is dedicated

to the topic of human brain function. This book is focused on assessing brain

function as it affects various aspects of the patient's capabilities from the

perspectives of the rehabilitation specialties. These specialties generally

assess brain function from a broader perspective than neuroimaging or even

neuropsychology. That is, they are interested in how the brain interacts with

the environment and impacts the patient's ability to manage practical aspects

of his or her daily life.

Notes/Comments:  Part I: Introduction Introduction to rehabilitation assessment Gerald Goldstein and Sue R. Beers Part II: The rehabilitation specialties Occupational therapy assessment of

adult brain function Margo B. Holm and Joan C. Rogers Physical therapy Kathye

E. Light, Marie A. Reilly and Martha Clendenin Rehabilitation assessment and

planning for neurogenic communication disorders Patrick J. Doyle Dynamics of

rehabilitation nursing Shirley P. Hoeman Geriatric rehabilitation Joan C.

Rogers and Margo B. Holm Part III: Assessment for rehabilitation Functional

assessment Michael McCue and Michael Pramuka Assessment of sensory and motor

function Paul D. Hansen and Lynette S. Chandler Assessment of external

prostheses Jacqueline Perry and Edmond Ayyappa Part IV: Clinical

considerations Rehabilitation assessment and planning for head trauma

Anne-Lise Christensen and Thomas W. Teasdale Neuropsychological assessment for

planning cognitive interventions William Drew Gouvier, Judith R. O'Jile and

Laurie M. Ryan Rehabilitation assessment and planning for children and adults

with learning disabilities Sue R. Beers Assessment and planning for memory

retraining Sue R. Beers and Gerald Goldstein Assessment and planning for

psychosocial and vocational rehabilitation Lynda J. Katz Cognitive remediation

of psychotic patients Robert S. Kern and Michael F. Green Index assessment

& rehabilitation of human brain function, patients with disorders

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